How long before levodopa starts working when first introduced?

[Slobber1]

I was diagnosed at age 70 about a year ago and prescribed Madopar 50/12.5, but resisted taking it until about 5 weeks ago by when a left hand tremor had developed to supplement the Bradykinesia, stiffness, awkward walking etc. Until now nothing’s happened. I was wondering whether it’s normal to take this long or longer, or whether the lack of improvement indicates that the dosage is too low? I note that the C/L equivalent Sinemet capsules/tablets seem to begin with twice the amount of levodopa content (100/25) than the Madopar. I’ve been very interested in the posts on thiamine, and will be keen to try it, but it’s probably best to establish the most appropriate dose of Madopar first! Many thanks for any responses. This discussion board is really helpful, a great find!

[Hidden]

Your dose is too low. Assuming you have determined the proper dose, you will feel the full effect 60 minutes after you take the first dose…

[Slobber1 in reply to Hidden]

It’s what my neurologist started me on. I'll just have to wait till the next appointment in July I suppose. Not keen on taking matters into my own hands so early in our relationship! But yes, it seems too low to me too - I suppose he judged me to be too early stage to start with a higher dosage, but it was before the tremor kicked in!

[Hidden in reply to Slobber1]

You shouldn't need to wait until July; call your doctor and he will tell you to increase it...

[ion_ion in reply to Slobber1]

The dr started me on half dose , too, for two weeks to get used to the medication and avoid side effects. After two weeks he told me to go the regular dose.

[Bruceyg65]

I started with 100/25 c/l twice a day and did not benefit. Moving to two 100/25 tablets twice a day solved my problems. My dosage has remained the same for 2 years.

[Hidden]

Vitamin B1 use instructions ;

Join Facebook group Parkinson’s thiamine hcl

m.facebook.com/groups/23226...

[Hidden in reply to Hidden]

Diagnosed 2012

My regimen:

The positives: no bradykinesia, I cut my food with a knife, no button difficulties, brush my teeth now w/o needing elect brush, more strength. Getting in and out of bed, turning over is easier. No more constipation. Parkinson's progression stopped. Suppressed all motor and non-motor symptoms...

Entering my 8th year post diagnosis and have not fallen, not once, to the surprise of my neuro.

B1 vitamin B1 (as thiamine HCL) 500mg, easy swallow capsules

B1 Thiamine therapy reference / stop progression, suppress motor and non-motor symptoms:

(Thiamine HCL is oral substitute to injecting B1) 2 x day (morning 2g and at lunch 2g)

Doctor Costantini strategy that I find helpful "thiamine hcl stops the progression forever...".

Parky people say the first five years is your honeymoon stage with Parkinson's. After that, progression more rapid.

I have gone from slow motion to normal motor action since joining the growing number of PwP that have started B1 regimen/protocol. –

Doctor Costantini - “Why is this? Because there is no medicine or drug that is able to affect all of the organs, whereas all of the organs function thanks to Thiamine. An important detail”, adds doctor Costantini, “the Thiamine therapy brings no collateral damage with time”.

[Hikoi]

Slobber1 many people find that holding off meds doesnt save them much as they have to start at a higher dose to get relief. So your dose may have suited a year ago but isnt sufficient now I suspect.

[Zella23]

Initially on diagnosis my husband was given the lower dose Modopar by the Neurologist to see how he got on with the dose, whether it helped and if there was any side effects and then reviewed after 1 month, where it was increased to 3 x day 100/25 for a year.

After a year 150/37.5 3 x day.

2 years on 100/25 4 x day.

Changed Neurologist after 4 and a half years.

Took B1 built up to 1gm twice a day and Magnesium. Plus other supplements.

Added in Azilect then Amantadine for dyskenesia.

Now reducing Modopar dose as noticed increase in restless legs and foot curling, with help from Neuro and now these are reducing.

Often forgets Modopar doses, yesterday only took 2 x100/25 and a half dose and felt fine. Walked over 3 miles during the day.

My husband keeps all his information and doses, symptoms etc on spread sheet.

Doing Ok at moment.

[Slobber1 in reply to Zella23]

Thanks to all for your thoughts - really appreciated.

[october61]

Which type of Madopar are you using? I think that there are 3 types..

[Slobber1 in reply to october61]

October61 it’s not extended release or the dispersible tablets, just capsules to be taken three or four times daily.

[Buffy007]

Hi - my husband has L H tremor. He's taken a catalogue of drugs of the past 5 years and none of them have worked. He never gets this 'off' period that people talk of, and he never gets this instant relief when he's taken a tablet. He might as well not be on them. And don't forget, tremor is the most difficult of symptoms to help with any tablets anyway. He's on the same dose as you, 4 times a day.

[childsplay]

My specialist says there is often a threshold effect, and indeed this was the case for me: I started with 100mg Levo 3x daily with almost no effect on my tremor & bradykinesia. Doubled that to 200mg Levo 3x daily, almost instant effect. Titrated that down to 150mg Levo 2x daily for a year or so, now back to 200mg either 2x or 3x daily depending on how I feel.

I use Madopar 200mg tablets, which can be easily be broken into halves and even quarters. I was once prescribed capsules without realising whilst at Dr's, the pharmacist was happy to substitute.

[Slobber1 in reply to childsplay]

Thank you childsplay. I think I'm on much too small a dose - only 50mg 4 times a day. I'm trying to raise to 100mg at least! Then I’ll try the B1 route also.