PD meds daily schedule

[slapdasch4]

Practically every neurologist I've encountered is pretty firm on the point that meds should be taken on the same daily schedule at the same dosages.

This recommendation is something I haven't always adhered to and I think I've had some decent results in not getting with the program. When I was still working, I often had classes to teach between 9am and noon. When PD symptoms begin to worsen, instead of accepting the neuro's advice to increase dosages, I began front loading meds so that I would be at my best when I had to perform in front of groups. True, I slowed down later but not so much that I couldn't deal with what I considered less stressful activities like faculty meetings and office hours.

In short, at least for me, I don't see a lot of harm in doing some experimentation with dosages and timing. This is an example of not blindly accepting what the doc says and being a bit of an advocate for one's self.

[johntPM]

I've never understood the idea that Parkinson's drugs should be taken to a strict timetable - except, possibly for ease of compliance. Doing this, seems to me like adding 10lt of petrol to a car every day, at the same time, regardless of when and how far you travel.

Forecasting your needs seems entirely reasonable.

I have for many years used "dynamic dosing". When my body indicates that it will soon need more dopamine, for instance an increase in tremor, I will take a dose of levodopa, hoping that it will come into play before I go "off". I almost never take 1 more pill than planned. Instead, I'm usually at least one behind.

It helps if you have a working knowlege of the pharmacokinetics (what the body does to the drug) of levodopa. It's mainly an issue of CMAX, TMAX, THALF, AUC.

[Seamus6]

I constantly play around with the timing of meds, I only take C/L, I think it could be trickier with DA's etc.

Recently, I've been taking my first Sinemet progressively later during the day.

I'm now at 4pm first dose.

Of course I'm a bit slow and stiff until my first dose but everything is utterly predictable(I can exercise) and the Sinemet seems to be more effective when I do take it.

Seven years in, I realised that taking Sinemet constantly (from waking) was taking me to an abyss.

I'm fortunate though as I can exercise without meds and I don't have to work.

[ConnieD in reply to Seamus6]

How much sinemet did you take per day when you were taking it all day?

[Seamus6 in reply to ConnieD]

Hi Connie...up to 6-7 100/25 every day (one every 2-3hrs) ...the off times were far worse than being unmedicated. I still take a CR 50/200 at bedtime which gives me a good night's sleep. Hope you're well.

[jimcaster]

I agree. When a drug like carbidopa levodopa only provides symptomatic relief, it seems logical to tailor dosage to times when symptoms are more problematic, such as stressful situations and/or exercise. Maybe, it's imaginary but I feel like I "burn up" carbidopa levodopa when golfing or bowling. I enjoy both of those activities very much and I modify the timing of my dosages to enhance my game.

[Buckholt in reply to jimcaster]

When I was first diagnosed I was told that exercise helps generate dopamine, but I would now say it consumes it

[bradykin in reply to Buckholt]

That's my experience as well (exercise consumes it).

[1LittleWillow]

I use mucuna instead of Sinemet, and this is exactly what I do. In fact, yesterday I was thinking about writing a post very similar to this one you just shared. I've been wondering if there's any reason NOT sticking with a schedule could be a problem (because I never do), but I haven't seen my MDS in a while so haven't had the chance to ask him. There are days when I take nothing other than my supplements, days when I take a small dose every few hours, and days (most of the time) when I take 1 or 2 doses per day. It just depends on how I'm feeling and what I need to get done each day. It seems to work just fine for me.

[Psalmody in reply to 1LittleWillow]

thank you I am in experimental stage between Mucana & sinemet because I think sinemet causes worse off time

[JeanieBeanie]

Agree with all said especially the exercise. After 28 years of PD all rules go out the window except don't let your dopamine levels get too low , including in the night.

[Divii]

thanks for the sharing; I agree with you. I am a YOPD pt diagnosed at 28 and now 11 years later, I will say what timing works well with dopamine is dependent upon individual.