Lots of OFF and Food interference

[rebtar]

I've been losing weight, hard to eat enough to maintain. OFF interferes a lot with both eating and exercise. I've been offered to consider Entacapone, Neupro patch, Apomorphine sublingual, Rytary.

All have pros and cons. I don't want to add to anticholinergic load, so as I understand, that leaves either adding Neupro low dose, or switching to Rytary.

I'm thinking trialing Neupro makes sense, as I assume I will know quickly how well it works, rather than going down the longer road of switching to Rytary, which also for some has the issue of food interference.

I'm not a gambler but do have some ADHD (not the hyperactive part) tendencies...but the worst has been that I tend to hyperfocus on things sometimes, spend too much time down rabbit holes. Can a low dose of Rotigotine cause worse impulse control problems?

I currently have a script for Inbrija, but it's not much use when I'm OFF -- doesn't have much effect on me, it does work some to extend on time if I'm already ON. Currently on close to 900mg of C/L daily, combining IR with CR to get a bit longer ON time.

Thoughts?

[park_bear]

There is a dose-response relationship of ICD vs, dopamine agonist dosage. Charts:

ncbi.nlm.nih.gov/pmc/articl...

[rebtar in reply to park_bear]

thanks bear, that’s very helpful.

[eschneid]

Hi Rebtar....I've been through the severe weight loss where I avoid protein like it's poison to avoid off time from the next 1-2 doses not working.I have tried from time to time dissolving my sinemet-mucuna mix after meals in warm green tea or other liquid with varying success. It seems to be helping me more this time around and I don't fear the protein as much.....some placebo, a better way to battle digestion-I do not know but its helping lately.