Balance with dopamine / choline receptors

[akgirlsrock]

Parkinson do we need to supplement choline or do we have to much choline, if we are not making dopamine will it cause to much choline and is that what causes tremors? I tried entacapone for 4 days and gave me dysknesia, I even cut pill in half, it seemed worse in the morning , I'm thinking my ER night pill is still in my system. Also I was feeling a wave of depression that I normally don't feel, had anyone had this feeling with entacapone. Thank you, Maria

[chartist]

Citicoline is much preferable than Choline in PwP. It has some synergy with C/L and may allow dose reduction of C/L possibly reducing the potential for dyskinesia. Then there are the potential anti-dementia benefits too!

Art

[LAJ12345]

Kemadrin or procyclidine is an anticholergenic. So does the opposite and is helpful to relieve the agitation caused by dopamine and ssri supposedly. Hubby takes 1/4 twice a day which seems enough to stop the levodopa agitation he gets. It can have bad side effects though so he is taking 1/4 of what was prescribed.

[akgirlsrock in reply to LAJ12345]

Thank you

[MarionP]

These are very common side effects, there are many and troublesome... You can look up "entacapone" on google and find many entries.

[akgirlsrock in reply to MarionP]

Thank you

[Hidden]

Hi akgirlsrock:

Consult with your doctor about adjusting your dosing plan.

My guess is that you are overmedicated and then become undermedicated, and your depressed feeling is due to the "crash" of dopamine levels.

oxfordscience.org/dopamine-...

"Fortunately for most of us, healthy brain neurosensors keep dopamine at manageable levels. But too much of a good thing can lead to a crash, much like withdrawal from a powerful drug. Even the most regulated brain cannot avoid the gloomy effects that a major change in dopamine levels can cause. When all the presents are unwrapped and we’re sitting around in a post-merriment torpor, the departure of all those feel-good chemicals can feel terribly gloomy."

Note that Entacapone can increase the amount of available levodopa by 33%!

In combination with using half tabs of Entacapone, consider also reducing the size of your c/l dose or increasing the time between doses.

accessdata.fda.gov/drugsatf...

"Dyskinesia

Comtan may potentiate the dopaminergic side effects of levodopa and may cause or exacerbate preexisting dyskinesia. Although decreasing the dose of levodopa may ameliorate this side effect, many patients in controlled studies continued to experience frequent dyskinesia despite a reduction in their dose of levodopa. The incidence of dyskinesia was 25% for treatment with Comtan and 15% for placebo. The incidence of study withdrawal for dyskinesia was 1.5% for 200 mg Comtan and 0.8% for placebo. "

[akgirlsrock in reply to Hidden]

Thank you, I did call Dr. and they said I could half the entacapone, I also tried one 25/100 and not enough for tremors, 1 / half only last for 2 hrs . 2. 25/100 sometimes last for 3 or less depending on protein intake, I ate cashew butter with banana , 1 hour after pills and tremors came back. Thank you for info , I appreciate the help trying figure out what helps😀

[Hidden in reply to akgirlsrock]

For me, it doesn't take too much protein before I go off, so I eat my daily protein amount almost entirely after the last dose.

IMHO, if you do the same as me, your on time will be what it will be, and I don't think there is much you can do about it. You need to stay between your lower levodopa threshold (ie, not under medicated) and you upper levodopa threshold (ie, not overmedicated). FYI, I currently get only 2.75 hours of on time per dose, and I count my blessings.