Medication Question

I was diagnosed with PD two years ago, but I've had symptoms for decades. I'm an American living in Thailand and I have no medical insurance, so at the moment am not seeing a doctor.

I have a question about medication. I take 1/2 Madopar 250 & 1/2 Comtan 200 twice per day. It takes about an hour for the meds to take effect, then they last for about 2 hours or 2 1/2 hours. So I only get 4-5 hours relief each day.

My last doctor suggested I take the meds 3 times per day plus a time released Madopar at bedtime. I'm hesitant to do this because my understanding is the more of the drugs I take the more likely I am to suffer nasty side effects. So, I'm operating under the assumption that by limiting medication I'll delay the onset and limit the intensity of side-effects. Am I correct?

10 Replies

  • Delaying meds does not delay onset of complications of med use. I take a lot of carbidopa levodopa 6 50/100 extended release and 6 25/100 carbidopa levodopa and 1 azilect and 1 6 mg requip every day with very few side affects. I am 11 years with Parkinson's. I take my meds every 4 hours 24 hours a day. I have maybe 1 hour of down time a day. I work out every day now sometimes 2 times a day 1 hour each time. i do weights, running stretching

    bike rides (15 miles at average speed of 16 mph). I believe that hard consistant exercise helps to control the side effects of the meds.

    Don't worry about the future embrace today take the meds and enjoy there effects.

  • Thanks. Even with the drugs, I have trouble walking & with my balance. This makes exercise difficult, but it seems to be the only thing that helps people so maybe I should push through the pain and do it!

  • You said: "Delaying meds does not delay onset of complications of med use." This is the exact opposite of what my Dr. said. This is all so baffling to me.


    Q. Is it true that taking Sinemet earlier in PD, decreases the medication’s long term usefulness? Does this apply to higher doses also?

    A. This is a myth. Levodopa is highly effective for many years, and its loss of efficacy has more to do with the progression of the disease than with the duration of treatment. Not all symptoms of PD respond to levodopa, and over time those symptoms become more prominent. Also, as the disease progresses, people tend to develop more side-effects from levodopa that can limit its use.

  • I really should start on Sinemet. It truly helps with tremors and studdering!!

  • I do much better with time release C/L. That is the only version I take. Steady even dopamine levels are what we are aiming for.

  • Thanks. For me the time-released version seems not nearly as effective. Perhaps that's because I don't take any Comtan with it.

  • jdc3, I only take Sinemet CR (controlled release) and no other PD meds. What dosage does your neurologist (?) describe for you? Everyone is different but many PPD are reporting that finding the dosage that works for you shud be a goal to strive for, to control symptoms and avoid side effects.

    Good luck 👍

  • no experience with meds, yet, but looking into medium chain oils that nourish brain even if you have insulin problems, apparently, ketones, the brain's preferred fuel, can safeguard, and even restore neurons, which is exactly what pd calls for. check out I got a very comprehensive article about coconut oil and mct oil(medium chain triglicerides) this am. you might subscribe to his newsletter.

    re exercise, you should aquaint yourself with Pepper's newsletter, he reversed his pd.

  • Everyone has a different medication experience. I was diagnosed 6 yrs ago at age 59. Currently I dose every 4 hours starting at 5AM with 2.5 tablets 25/100 carblevo ODT (oral dissolving tablets). Meds in the beginning would take 15 min to kick in, now it sometimes takes an hour. At 5AM and 1PM I take 1 tablet Selegiline (5mg). At 9PM I take 1 tablet carblevo and at 10PM 1 tablet 50/200 carblevo ER (Extended Release). Sometimes my meds keep me ON for all four hours between dosing, and sometimes I run out of gas (OFF) after three hours. Everyone is different. Take your meds same time daily. Keep moving stay active. Exercise is the best medicine!

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