How to estimate the short-term benefit of carbidopa/levodopa

[johntPM]

One of the common symptoms of PD is bradykinesia (slow movements). You might, for instance, type more slowly when you are "Off", rather than when you are "0n".

A good measure for bradykinesia is the side-to-side tap test. In this test you sit at a computer keyboard and, using just the index finger of first your left hand, you type q followed by p, and you repeat this as many times as you can in 30 seconds. You repeat this with your right hand. An app to measure this can be found at:

parkinsonsmeasurement.org/t...

High scores are good, low scores are bad.

You can use this test in the following way. Start first thing in the morning, when you have cleared the effect of most of the prevous day's C/L from your body. To form a baseline, you run the test at time T-20 minutes, T-10 minutes, T. At which time you take your dose. You continue taking the test every 10 minutes for as long as it takes to get the scores to come back to the baseline.

To get an estimate of the benefit from the dose, you can draw an horizontal line from the baseline and measure the area between the baseline and the tapping score. One way to look at this is to say that the dose buys an extra number of taps.

Of course, this approach could benefit from a proper statistical analysis. But, it does seem to me to be a practical measure, useful when you are experimenting.

John

[ruff1]

Can I ask why Stelevo is taken with Movicol ?

[johntPM in reply to ruff1]

I'm sorry I didn't make the significance of the graph clear. It is just illustrative of what can be measured. You are more than likely to have different areas of concern.

Stalevo ( which is levodopa/carbidopa/entacapone) along with Movicol mixed in vitamin C solution was just one of the experiments that I've done. These are all drugs that I'm taking. I was wishing to fine tune the regimen by possibly moving Movicol from taking on going to bed, to taking on getting up. In the end I chose not to move it.

[sharoncrayn in reply to johntPM]

in reply to jpm,

Movical is a commonly used LAXATIVE. nothing special. Stalevo 75 is the weakest version. Generic is available.

I would consider Vit C somewhat in that same category (laxative) if taken in large amounts (in grams!).

considering the limitations of the graph, the Stalevo 75 graph mirrors ER100 sinemet's duration graphs of 90-180 minutes, which is totally expected if adding entacapone does not always improve duration ( plasma half-life), which it might not. might be in other cases.

regardless, a very definite efficacy period for these common PD drugs.

sharon