More Sinemet, Comtan Needed At Night Than... - Cure Parkinson's

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More Sinemet, Comtan Needed At Night Than Day

gl2238 profile image

Just curious it seems that in most of the posts I have read, the reference to Sinemet use is mostly during the day and minimum in the PM with the only issue in the following morning is Akinesia. During the day I can go 4 to 6+ hours on each 25-100 Sinemet/Comtan. During the night I wake up about every 2.0 to 3.5 hours with my PD symptoms. I have multiple issues including global neuropathy. I need to take a Sinemet/Comtan dose to "Quiet" the system, so to speak. Do most persons sleep through the night? How many PWPs can make it through the night without having to take supplemental medication? I have gotten to the point where I am fearful of the PM.

25 Replies

I include pm dosing

gl2238 profile image
gl2238 in reply to RoyProp

Thank you RoyProp for your response. I use more RX from 12:00 AM to 7:00AM than the remaining 17 hours of the day. You would think the "Sleeping Hours" would be less? I would love to be able to go to bed earlier but can't!

Hi gl2238, I don't don't take any levodopa during the night (since I have no symptoms then which inhibit sleep). I suppose this may change as the disease advances...

gl2238 profile image
gl2238 in reply to Levod

Maybe you will be one of the lucky ones. I wish you well for the future.

DrewE profile image
DrewE in reply to gl2238

My situation is similar to Levod’s, no night time symptoms and plenty of stiffness but no tremor when I wake up in the morning.

Why not use a timed release version?

gl2238 profile image
gl2238 in reply to park_bear

Thank you park_bear. Neuro had me try CR. Total added time of sleep between doses, increased by 30 minutes or so. The reason it is so small a time is that since it takes longer for the CR to get into your system you have to take it up to an hour or so before you would take a regular formulary. The violent shaking of my left hand and severity of abdominal pain/tightness, which wakes me up, is, at times, more than I can bare. I have not tried the inhaled Levodopa yet. There is another product called Nourianz, he wants me to try but the potential side effects are nothing to laugh at.

Despe profile image
Despe in reply to gl2238

Have you tried Magnesium and/or Melatonin? I highly recommend both.

Marimar70 profile image
Marimar70 in reply to Despe

I give my mother a banana before she goes to bed along with carbidopa levodopa

Despe profile image
Despe in reply to Marimar70

I am not a doctor, but why the banana before bed? Try Magnesium L-Threonate, three capsules a day, last one you can give to her with her C/L. Melatonin is for insomnia, REM and then some! If you search this site, upper right-hand block "Search HealthUnlocked" you will find numerous posts on Magnesium and Melatonin.

You may also try Magnesium Oil for pain or tightening of muscles.

Marimar70 profile image
Marimar70 in reply to Despe

I figured since it has some magnesium in it will help. Reasons why I give my mom a banana is for cramping at night and for sleep.

If you think a supplement will help better.. I can discuss with my brother who also isy mom caregiver.

RoyProp profile image
RoyProp in reply to gl2238

Did you try Inbrija ? What happens?

That is what I use 1 quick and 1 time release.

I take 1 instant release and 1 extended release together. After 1st dose of the day I can go 6 hours. But the 2nd dose only lasts 4 hours. No matter what I'm doing that's what happens. I take a dose before bed and sleep 6 hours.

MarionP profile image
MarionP in reply to Rocke

I think you have the answer there, taking care of remember that people need to notice that continuous release and extended release are not the same, and that you were talking about er, extended release

My worst time is evening to the point a fall now. However, the Dr. told me nothing will help the falling.

My hubby goes to sleep fast but will awaken in early am, go to Livingroom and fall asleep in he does often during the day. He takes 2 Sinamet in the Am, then a saligiline during the day. Do these meds make him more sleepy? What can reduce this other than coffee which he drinks a lot of. Part of his problem is that I don't fall asleep easily despite taking a Doxepin. Then I sleep late but he can be awake in AM tho he sleeps too. Going somewhere is difficult for us both. We feel totally out of life. Right now we are in a retirement home so kids can fix up house, 2 meals provided, and he can get to breakfast but I can't. I just have toast. We get to dinner at about 5pm. He doesn't really say how he feels but tremors seem less. I need to know, tho, what's going on. He gets off balance in the eve when I notice it more and can fall but not as much as when at home with stairs. Apathy is our big problem. I have Fibromyalgia/chronic fatigue and take a generic Provigil to awaken my system a bit but not in the eve. Could he take that since he only takes Sinemit and resigilin, not selegilin. Sorry for spelling. One of the agonists caused falling at home to where getting him up was a problem. We take vitamins, multi, CoQ10, Vit D in the eve but I suspect he's not taking the Vit B complex in the AM, with Sinemet, and I wonder if magnesium should be added. Should he take them all in the AM ? I thought they should be taken at different times for some reason. I hesitate to have him take a lot of any Vit. M.A. In USA. He has had PD for at least 8 years. Thanks.

Despe profile image
Despe in reply to grandmama16

I highly recommend based on my husband's experience:

1. B1 (HCL)

2. Magnesium L-Threonate

3. Melatonin

4. Vitamin C

5. Vitamin D

grandmama16 profile image
grandmama16 in reply to Despe

Thank you. Should he take them all at once? What time of day? He gets mild hallucinations in the eve. He takes Vit D, in the eve with Multi. Then at bedtime he takes Meletonin. Seems to work. Have to get magnesium. He has the combo B's but not sure when he should take them. He takes the RX on his awn but not vitamins. I have no idea why. Being 78? So far we're lucky...he doesn't have wild movements...mostly balance and getting going walking. I like the picture of your little dog. Looks like ours which died in Nov. heart. He was diabetic and so hard to give him shots.

Despe profile image
Despe in reply to grandmama16

Some vitamins are water soluble and some are lipid soluble. Vitamins C and B1 (HCL) are water soluble which means they can be taken on an empty stomach. Vitamin D is lipid soluble which has to be taken after a meal. Magnesium (one capsule) can be taken along with his Sinemet and B1, one with his mid-day Sinemet and B1 (depending how many mgs of B1 he is taking. Third Magnesium capsule an hour before bed time. Also Melatonin an hour before bed or even start earlier, depending on total of mgs he is taking.

Best to take his multi vitamin after breakfast. All these suggestions are based on my husband's experience.

Age is a bitch, hahaha. :) :) Thanks for my dog's compliments. He passed away 13 years ago. He was like a son to me.

Despe profile image
Despe in reply to grandmama16

I would like to thank all you wonderful folks for addressing an area of PD that doesn't come up for peer review very often. When I wake up it is not a pretty sight. My left arm is literally flailing (shaking violently). Falling asleep is not usually a problem. I have tried all the recommendations as outlined in the various posts. Recently, I tried an experiment. Instead of PD RX, I tried .5mg Ativan (Benzodiazepine), Shaking subsided in about 30 minutes and fell asleep for another four hours at which time I took the usual PD RX. I also tried experiments with 5mg Oxycodone, Oxy also worked in allowing me to sleep in addition to reducing pain which I have 24/7. Results so far have been a better sleep sometimes up to 7 hours with no hangover.

I have tried the Magnesium and Melatonin and the banana with no success. I guess everyone has their own solution ( I hope), to the getting enough sleep issue. Neuro has suggested that since Ativan and OXY target the CNS (Central Nervous System), it quiets the arm flailing without interfering with the PD RX drugs. Now every other time I wake up due to shaking, I take 5mg Oxycodone (not Percocet).

I also tried, upon suggestion from Neuro, to try CR. Result - Total failure, these are two different products with different characteristics. To be effective you have to take up to an hour before final Sinemet/Comtan for the evening. Result is the same forced wake up time.

Again, thank you all for your suggestions.

You are not alone. I dose every 2-3 hrs all day and night. My off period is so severe that my med level is 2 (tabs) 8x a day. Of course this dosing has made matters worse by increasing the PD side effects. I am now going through DBS counseling. And life goes on

Using a night cap / toque. Seems to help.

To get through the PM I take my two tabs at 9, 12, and 3

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