Inconsistent response to Madapar

[jag73]

Can anyone shed light on my problem.

I have good response to Madapar from 7am through to about 2.30pm. My 2.30 dose seems very slow to work, sometimes not at all well. My down time lasts for 2-21/2 hours. This trend has been hard to sort out and is quite inhibiting. I am taking 5 x 250mg Madapar a day and don't want to increase my dose.

Your ideas on the subject would be appreciated.

[Glenn54]

Hi ,Jag 73,How long diagnosed? Because from my experience diagnosed 2003the longer time youve had parkiesthe less reliable the oral medication becomes and you experience Dose Failure due to this problem iv just started on apomine infusion 24hrs a day this has given me more ON time and less oral med per day

[johntPM]

For a dose to be effective, enough of it needs to reach the brain to make up for the shortage produced by the body. A delay getting from the stomach to the upper intestine can be caused by delayed gastric emptying - perhaps, caused by fat in the diet. The delay in getting absorbed from the upper intestine can be caused by protein in the diet. Moreover, any delay in getting through is likely to lead to less of the levodopa reaching the brain.

There is also likely to be a threshold effect. Too little levodopa means that the threshold required to get "on" is never reached, leading to "down time".

I would look into whether shifting the time and contents of your lunch makes a difference.

John

[paddyfield]

I sometimes experience this about 2.30 with sinemet. My neuro once asked me whether I experienced any times when the sinemet did not seem to be working as well and it seemed to chime with whatever he was already thinking about when I mentioned the dip around 2 pm for a couple of hours.