Dyskinesia

Theory...Levodopa is active for two hours. After which your body is free of levodopa resulting low risk of dyskinesia.

One takes 100mg per dose. 8 doses per day. Or

One takes 400mg per dose 2 doses per day.

Each provide 800mg total per day.

Your risk of dyskinesia is lower at 100mg per dose while maintaining the same high dose day. Multiple low dose protocol allows higher daily levodopa.

Reference: Mayo Clinic. “Cheaper, Simpler, and Better: Tips for Treating Seniors With Parkinson Disease”

J. Eric Ahlskog, PhD, MD

[ion_ion]

Dyskinesia is caused by high variations of the medication level. Keeping the level constant prevents it.

[Hidden]

Hi Roy, You are basically correct when it comes to "peak dose" dyskinesias - you don't want the individual doses to be too high, but on the other hand you also don't want the individual doses to be too low.

[johntPM]

To see what's going on, you can use:parkinsonsmeasurement.org/t...

This app shows the variability of levodopa plasma concentrations during the day. For instance, carbidopa/levodopa gives:

8 by 100 mg doses has a maximum of about 160 LED.

2 by 400 mg doses has a maximum of about 410 LED.

levodopa, 8 x 100 mg doses

[Hidden in reply to johntPM]

Thank you. I HAD a copy at one time.

[jeeves19 in reply to johntPM]

Excellent App John. Thanks 🙏

[Doohat]

Note: Dr. Ahlskog does not recommend higher individual levodopa doses if you have short-duration levodopa responses (ie. motor fluctuations). It's better to go with a shorter dosage interval than to go with larger individual doses.

"Short-duration levodopa responses rarely benefit from higher individual levodopa doses; increasing the dose does not translate into substantially longer responses. The appropriate strategy is to determine the duration of the response and adjust the dosing intervals to match the response duration. Clinicians are sometimes instructed to reduce individual levodopa doses if administering carbidopa/levodopa more frequently; however, this is not an advisable strategy. The carbidopa/levodopa dose should be the one that produces the most benefit. The number of doses or tablets per day is not important, as long as they are appropriate to the patient's needs."

[PalmSprings]

Ooh thanks! I’m going to try this!

[Godiv]

It gets confusing with an extended release like Rytary. And for some reason the doctor didn’t tell me about the peak dose issue. Or maybe they did and I didn’t hear it. And I would get in to the dosage I mean having taken my dosage, and would get all weird and wiggly and not able to walk well, so I would take a little extra of the inhalable stuff and really be wiggly. And puzzled LOL. I think I have a slightly better handle on it now. Thank you for all this information; it’s really helpful.

[Wonky-Bride in reply to Godiv]

Godiv, it’s worth getting Ahslkog’s book to read and refer back to.

[Godiv in reply to Wonky-Bride]

I love your user name! OK thank you so much I will do that. It sounds very helpful.

[CarolFroberg]

Think I need a long talk with doctor or new doctor.