Off periods?

[kaypeeoh]

I can guess the answer is, "It depends..." But I'll ask anyway. After a dose of Sinemet the PD signs diminish but eventually return. That's the OFF period, as I understand it. How long does the Sinemet last? Why can't I take more Sinemet once the OFF period starts? Once I start Sinemet, how long before a positive effect? Some drugs, like SSRIs, take time to build up in the body before positive effects happen. Is that the case with Sinemet? Or is there an instant improvement the moment the drug is absorbed, rather than days or weeks later?

TIA,

kaypeeoh

[Hidden]

Q: How long does the Sinemet last?

The answer depends on the person, and how far the disease has advanced.

I started at 5 hour dosing intervals, and am now at 4 hour dosing intervals. I am currently investigating 3.5 hour dosing intervals...

Q: Why can't I take more Sinemet once the OFF period starts?

You can. When you first get the disease you might typically take 3 doses, which you should overlap slightly such that you don't go off in between (e.g., for 3 x 5 hours = 15 hours)...

But after the 3rd dose you will go off... but in the beginning it will not be too bad... and most of the time you will be sleeping, until you start over the next day...

Q: Once I start Sinemet, how long before a positive effect?

instantaneous release (IR): ~60 minutes

controlled release (CR): ~90 minutes

Q: Some drugs, like SSRIs, take time to build up in the body before positive effects happen. Is that the case with Sinemet? Or is there an instant improvement the moment the drug is absorbed, rather than days or weeks later?

They will take effect immediately after the times listed above.

[kaypeeoh in reply to Hidden]

Thank you for the excellent response. My goal is to find out whether PD is the reason for my balance problems. IF so, Sinemet may help. Just more self-experimentation.

[Ramondo in reply to kaypeeoh]

Sinamet is not helping my constant balance problems,still looking for help after many falls.

[CaseyInsights in reply to kaypeeoh]

Rivastigmine - a drug used for Alzheimer’s may help with balance problems.

"With the degeneration of dopamine producing nerve cells, people with Parkinson's often have issues with unsteadiness when walking.

"As part of the condition, they also have lower levels of the chemical acetylcholine, which helps us to concentrate. This makes it extremely difficult to balance and walk at the same time.

"We already know that rivastigmine works to treat dementia by preventing the breakdown of acetylcholine, however our study shows for the first time that it can also improve walking, regularity of step, speed, and balance.

"This is a real breakthrough in reducing the risk of falls for people with Parkinson's."

parkinsons.org.uk/news/comm...

Don’t know what stage this effort to repurpose this drug has reached. This is a 2016 article.

Here another take on the importance of acetylcholine for PD -

goodtherapy.org/blog/psychp...

The drug Rivastigmine prevents the breakdown of acetylcholine, so maybe a supplemental route, increasing acetylcholine production might also work. In that case Phosphatidylcholine combined with Acetylcholine L-Carnitine (ALCAR) may do the trick.

[CaseyInsights in reply to CaseyInsights]

...and you can learn more about these two supplements here -

ALCAR: nootropicsexpert.com/acetyl...

Phosphatidylcholine: nootropicsexpert.com/phosph...

[Cagey84 in reply to CaseyInsights]

Clinical trial under way to assess rivastigmine in falls in PD clinicaltrials.gov/ct2/show...

[CaseyInsights in reply to Cagey84]

Good to know. Thanks 🌺