Increased sinemet 25/100 from 3 x daily to 4 x to deal with tremors and have no appetite and significant weight loss? How to cut back?

Won’t see neurologist for 3 weeks to ask him.

[Grumpy77]

Its not very clear to me what you mean,..,. whether the weight loss and loss of appetite is before or after the dose increment, can you explain more. Otherwise three weeks is not too long... for best advice you should be asking your neurologist really. He can have a better close up examination of you, knows your parkinson's medical history and as a specialist is more knowledgeable than most of us here

[Hidden in reply to Grumpy77]

Weight is after dose increment as well as sleeplessness, trouble falling asleep and staying asleep. I see visiting neurologist once a year since 2018. Any concerns I have he defers to the next appt

[Grumpy77 in reply to Hidden]

Wow, so if you raise concerns in February 2022 when you meet him, he would not address those concerns until February 2023!!? When things would have changed and new issues would have arisen?? That's really very bad. I think, for your own good, you should find another neurologist

[Hidden in reply to Grumpy77]

He will address my Feb 22 concerns and I will have to see find out how to access his help if those issues aren’t resolved. He visits our community once or twice a year. In all fairness I haven’t required his service more than that til now. I will let you know how it goes next visit.Thanks

[ddmagee1 in reply to Hidden]

Seeing the neurologist once a year, just doesn’t seem like enough, but, if a patient is relatively stable, in the neurologist’s opinion, then, I guess, they feel it is justified!

[park_bear]

Small changes in dosage can be made without danger of serotonin syndrome. Serotonin syndrome can occur when people taking large amounts of levodopa, typically around one gram daily, quit completely.

[Hidden in reply to park_bear]

Thanks park_bear

[DachshundFan]

My neurologist responds to emails within a day, and it is usually with a phone call. Sometimes the PA responds.

[Hidden in reply to DachshundFan]

Wow. That’s great,8

[Hidden]

Titration / TITRATING / Titrate

Copy from outside resource. Please have your case managed by your doctor.

“For patients on high doses (over 1000 mg levodopa), we recommend reducing levodopa by approximately 100 to 50 mg per day, (for doses over 500 mg levodopa) 25 mg to 50 mg per day, and for lower doses (less than 500 mg/d) 25 mg less every second or third day.”

I am going through dose adjustment. I lowered B1 to one gram daily.

I need to determine the safe way to titrate down my c/l.

Currently two tablets, 25/100 IR at six times a day/night. 24 hrs.

[Raphaekg]

I have zero appetite and significant weight loss. Twelve years since diagnosis. Gastroenterologist recommended Ensure. Yuck. A LONG ingredient list. I am now trying various vegan liquid meal substitutes. Have to time consumption to not have protein interfere with med absorption. But I think that this will be a tolerable way to slowly gain some weight.

[Hidden]

Thank you