Since having PD I have become just a little obsessed with reading and understanding all I can about it and this is a bit of what I have learned. I hope it is useful to somebody.
I was going to put some of this in a reply post but it is general information. It is not meant to be advice about your treatment but it is about understanding our treatment so hopefully we can feel more in control. I believe it is accurate but welcome corrections or comments.
The pills: Can you split them.?
Some people do this. You can't do it on every type of pill but in doubt your pharmacist will know.
If there isn't a line down the middle you can buy a pill cutter very cheap at pharmacy or $2 shop. This means the halves are equal so you know what dose you are getting and it is consistent.
You can't split long acting meds because the outer coating is what makes it absorb slowly. Ie makes it long acting or extended release. Splitting the med exposes the inner part and in effect makes it a short acting medicine.
all meds have an average absorption time. The Drs etc will talk about the half-life of a drug. This is the time it takes for the amount of it in your body to be reduced by half. This depends on how the body processes and excretes the drug, and can vary from a few hours to a few days. No matter what dosage of a partiular drug you're on or how long you've been taking it for, its half-life is always the same.
Guess what levadopa ( sinemet, madopar etc) half life is 60 - 90 minutes!! Research shows that altogether it lasts up to 3 1/2 hrs. Not long is it. In the beginning you can store a bit so once, twice or three times a day medication regimes work. But later you don't have the same ability to store any. So that's why in general the longer you have had PD the more frequently you need meds. After a few years taking a pill every two to three hours is quite usual.
It is wise to be on as low dose as possible but if the dose is too low then you can have a problem getting to an adequate level for it to be effective. Some people find they need a boost dose in the am to get their level up for the day for example.
If you then have a long gap before the next pill you are likely to dip very low and again the next dose has catch up and can take an age to raise the level of dopamine in the body and it becomes a fluctuating on off type cycle. Smaller doses more frequently is the usual answer. You get the same amount of levadopa over the day but maintain a more consistent level in your system.
So you can see how our medication regimes can become very complicated and personal to us. They are affected by our lifestyle, activity levels and metabolism and much more. If we understand what is happening we can try little changes to get the best possible effect from our drugs.
I find that the more I understand the more actively involved I can be in treatment decisions and so the more control I feel I have over my world. Hope you find that too.
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