Neurologist's tips for taking SINEMET

[@elpasotexastejano1]

In one minute you gave me more information than my neurologist has ever given me in the past six months since I was diagnosed thank you! You are God sent!

[@AndrewReevesNeurology]

Well, thank you! It's really a sad thing, though, isn't it? People need to know about their medicines, diagnosis, etc., and doctors should be good at explaining and partnering with people. Best of health to you!

[@rickypastille]

Agree 100%. My 'very busy' neurologist basically just said "Take 3." You are indeed a God-Send, Andrew. You have no idea how valuable this has been to me.

[@mutualinduction139]

Physical exercise should be ur lifestyles and cbd oil hemp

[@naimepeker3683]

​@@rickypastille pll l Leo

[@steveaird9347]

See a neurologist movement specialist not just a Neurologist

[@OakstoneWolf]

Thank you for this information. I was diagnosed with DRD a few months back, and this video shared a few things I didn't know before. Thank you for your hard work and you taking the time to share with us your expertise.

[@AndrewReevesNeurology]

DRD...now there's a not-so-common disorder. I hope yours if the form that stays sensitive to levodopa long term!

[@OakstoneWolf]

So far so good. We can definitely tell when I'm in need of my next dose. Extending the sinemet out via comtan has done wonders. The symptoms never fully rectify, but we receive enough correction that I'm able to function much better than before. May I ask if any contraindications between levodopa and melatonin exist? I read an NIH study showing that melatonin acts as a dopamine antagonist and can negatively increase the physical aspects of PD. I was curious if the same can be said regarding DRD, and if melatonin might inhibit sinemet's effectiveness.

[@gdowe1393]

@@AndrewReevesNeurology njuuhhh. 6:24

[@williammcdaniel6278]

Thank You for this information I’ve been taking this wrong for the last four years . I’ve always taken this with food. Thank You again !

[@CaliGal_17]

Thank you so much for the video. I have been wondering about the C/L ratio and you explained it beautifully.

[@helenhallas9545]

Thank you so much, I was diagnosed with parkinsons 8 years ago and take sinemet 4 times a day and have never been told that information. Hugely helpful, thank you again

[@AndrewReevesNeurology]

Glad I could help, and I wish you the best of health!

[@davidwend9229]

Protein is a very important part of my diet, because of my fight against muscle atrophy due to age and Parkinson’s. Knowing when not to eat around Sinemet consumption was very important to me, particularly the 90 minutes after. I do have night issues so currently I take 25/100 three times a day. 6:00 am, 3:00pm, and 10:00pm. Still I often find myself with whole body shakes around 4:00 am. If I didn’t have the slight overlap of dosing at 10:00pm, I’d be up all night it’s leg cramps and spasms. Thank you for your clear tutorial. I might ask to have a slow release version of Sinemet for when I go to bed around 8:30pm. That way I can move the 3:00 to 2:00 and avoid any off time which I have been experiencing.

[@manowargoblin]

Same as me, but I find taking them at 8-9am, noon-1pm & 5pm better as I can cope with off period better in the evening/overnight

[@richardblackith2520]

​

[@tyroneearnest]

Hello Dr Reeves, I appreciate your video. I'm a fairly new nurse LPN, worked in a SNF for 9 months and started working in a neurology clinic about two months now. As you well know we deal with PD quite a bit. Dosage and regimen is a constant issue. Today I was at such a lost as how to direct a certain pt and family member. Most of the time patients and their caregiver are not following the regimen. At least that seems to be the issue as I see it now. After watching your video, I see that I am going to have to study up so I can better aid these patients and caregivers. The SNF was a physical hustle all shift long and then some, the neurology clinic is a mental hustle and just as exhausting. I like it, lots to learn. Thank you.

[@AndrewReevesNeurology]

Glad you found it helpful, Tyrone! You're right, dosing and regimen is a constant issue in PD management. Even when they're spot on, day-to-day fluctuations still cause issues. Best of luck in your new job!

[@AngelineMingia]

Thank you for the info. I didn’t even understand the make up of the medicine until now. I stopped taking mymed when it made me sleep around the clock. I smoked marijuana now during the day instead of taking the medicine. Usually during the course of a day now I consume one pill and two doses, and at night I take a whole pill, mainly to keep it in my system and help a little bit with the shaking. the marijuana is a particular brand which leaves no desire for food and doesn’t put me to sleep. And best of all helps with the tremors. Lymphatic massage has also been very helpful. I go for an hour once every 10 or 15 days​. 6:24 @@AndrewReevesNeurology

[@colin101981]

Thank you so much Dr. Reeves for posting this video. I'm at the beginning of this journey, not yet on medication. I'm finding the non-motor problems very difficult to deal with. Just waiting to see my GP (I'm in the UK). I really appreciate your open, honest and even humorous way of describing this treatment. You must be busy and that makes me appreciate your generosity more. Warm greetings from North Wales UK.

[@AndrewReevesNeurology]

Thanks for your comment. Perhaps I should do a "non-motor PD problems" video some day.... Hmmm....

[@colin101981]

@@AndrewReevesNeurology That would be very much appreciated. Kind Regards Colin

[@fishnlady]

I recently listened to a video from the Parkinson’s Institute, where they say that the medicines that treat the physical manifestations of Parkinson’s actually brings on the hallucinations and other mental issues. My mom did not have any problems with seeing things or hearing things that weren’t real until she had been on carbidopa levodopa for awhile. It would have been wonderful if her doctor would have told her this could happen. I think she would’ve suffered through the tremors rather than exchanging help for the tremors to be plagued with hallucinations and hearing things. Health care in our area is pathetic.

[@EnlightenYourself206]

Same thing with my dad. Have you tried taking her off meds? Just curious...

[@fishnlady]

@@EnlightenYourself206 Of her own doing she has been off all medications for about a month. She is better but still not quite back to normal. Maybe she won’t ever return to normal but she is better not taking the medication. Thanks for asking.

[@steveparsons6965]

Thank you for this very simple and informative presentation.

[@TheLordsweapon]

Thank you, this vid answers straight forward questions i had, right to the point, God Bless!

[@AndrewReevesNeurology]

Glad you found it useful! God bless you and stay healthy.

[@viproo6302]

Succinct, precise, simple. Thank you well done! 👏

[@paulthompson1216]

Ditto. Thank you! Great Christmas gift.

[@rafordy]

Excellent Video

[@suetheotherbruce759]

Extremely useful!!! Thank you

[@Trish-ql9kz]

My husband newly diagnosed has been taking this for three months with very little positive effect, waiting to see neurologist

[@videomanic411]

Interesting, my husband has been prescribed the meds but we have not taken them yet. We are trying to stimulate his dopamine levels through walking exercises and anything we can think of. If the meds won’t help slow down the disease, why take it? They have enough problems as it.

[@paxetbonum4420]

@@videomanic411you can do both. Go on Mediterranean diet. Eat plenty of vegetables and some fruit esp blueberries and fish. Salmon is best. Lots of Omega 3 and lots of flax seed. Take your medicine also. Remember to exercise daily.

[@paulinedonovan8381]

you're both informative and funny in a quirky way which I love as I'm sleep deprived as a care partner punch drunk may be the right term... LBD w/ parkinsonism thank you

[@obsoleteprofessor2034]

I'm caring for mine. How can I complain...2 hours max sleep per night because she needs help to potty and had retention problems. ..but she can't sleep either plus is suffering with the progressing disease.

[@susanraetulsa5679]

Have you had any patients that report the feeling of shortness of breath with sinemet? Every time my mother starts taking it by day two or three she gets this feeling that she has to take a lot of deep breaths. Her oxygen level is always find as well as her blood pressure. She is on no other medication. She’s had Parkinson’s for 7 years but because of high activity is just now starting to scoot her feet a little, she has tremors on both sides. Still cooks, does laundry and keeps up her house. If she can’t take sinemet we were told by her neurologist that there is no other meds for her to try. Stress & anxiety of course make her tremors much worse. Would any anxiety meds help at all? Her doctor has been talking about her trying medical marijuana. Thank you in advance for your reply. She loved the video! God Bless YOU!

[@AndrewReevesNeurology]

Many drugs can cause a feeling of shortness of breath. There are several medications besides Sinemet, such as ropinirole and pramipexole. There are few others which are not used quite as commonly.

[@teresakelley4463]

I read that she is having these symptoms because the medicine is wearing off on her. I hope this helps. My husband takes Carbidopa levodopa 4 times a day and Carbidopa levodopa extended release at bedtime. I'm not saying she needs that amount but I read that she's having these symptoms because her medicine wore off. I hope this helps.

[@obsoleteprofessor2034]

My wife's neurologist suggested meds for anxiety, but that just adds another pill and side effects. Try and get yours to learn the Wim Hof deep breathing technique. Might help...

[@micheleberg3090]

Very helpful! Thanks!!

[@lorenzomaximo1818]

I have Parkinsons and take 2 25/100 C.L tablets 4 times a day. 7 am 11am 3pm 7 pm and don't get much relief. I'm fine at rest watching tv or just relaxing but when I do work around the house or yard its like I'm working in a telegraph office. My right arm and right leg are the worse for tremors but it is now spreading to my left arm. Getting weak and losing motor functions on my left side. Also I have lost most of my taste and smell the last 12 years. I can taste certain things but mostly may taste is shot. I can't smell things as they should be. Some foods being cooked have an offensive odor. I can smell smoke and gasoline though. Its really depressing not being able to enjoy food. BTW I have no history on either side of my family. I am a Vietnam vet and believe I was exposed to Agent Orange and filed a claim but got denied. I appealed and am waiting 2 years now for a resolution. This is a horrible debilitating disease.

[@johnbertinelli5236]

H

[@limsa6968]

Thank you so much, I like you both do a presentation on parkinson's disease..

[@sofieattrill9034]

Really useful, thank you

[@rosemaryclarke6250]

It's all written on the bottle of tablets when you get it from the pharmacy

[@FullTimePatient37]

I'm on it for general dystonia..i can barely move or do anything and i have a lot of tremors..i just want to work 😢

[@ELVISRN1]

excellent vid

[@paxetbonum4420]

Thank you great info

[@thirstforfruit5825]

Can you make a video talking about the difference or not in AED Generic namely tegretol and keppra... thanks

[@AccessN2Grace]

Wonderful!! We were told to take it with food. No wonder haven’t seen any results. Thanks for the video!!

[@hamadam2557]

Thanks Doctor

[@GoldenAgeDave]

Thank you so much for this. I was diagnosed and given this medication. Today is my first day. Besides my body issues I have really struggled horribly with focus and concentration. By getting uptake in dopamine can this medication also help with this issue as well? Thank you very much.

[@nystagmus]

When do you start a person on sinemet? I heard to hold off taking sinemet until you get to a certain point in parkinson disease.

[@carlos.9957]

before taking any levodopa drug, pls be warned that it gives addiction as prescribed today (same as eroine with eavy if not lethal withdrawal syndrome). Too much drug since the beginning gives rapid saturation and resistance and need to increase dosage with rapid addiction. Levodopa consumption in brain is minimal (mcg) and the missing quota is even lower. A drug (like levodopa) can take weeks to reach the center of the brain and be effective; starting with mg of current drugs (pure levodopa with a concentrator) may be immediately effective because of the huge quantity of drug - this is the main mistake. it will shock the entire brain tha will defend itself increasing resistance (i.e. reducing sensibility to the drug and developping methods to protect itself from or get rid faster of the toxic drug). As the result a disease that took 20 years to manifest will acellerate progression and will require more and more drug that will cause more and more brain damage in a negative loop - but the cause will the drug (and the concentrator, that will cause a cronic vit B6 deficiency) not the disease. Alternatively mucuna pruriens powder can be much better in the long term. Only take care to start at very low dosage (easier because levodopa in mucuna is approx 5% and without the concentrator only 1/10 or 1/20 reaches the brain; in addition taken with food compete with other aminoacids thus with 1 gr of powder x day you can have 1 mg or less of levodopa reaching the brain and be sufficient to control symptoms for th rest of your life without side effects - not 100/300 mg flooding your brain daily giving in 5 years the known probems). if no effect, increase it every 2 months until desired terapeutic effect is reached. Then you will likely stay on this level for all your life without addiction or end of honey moon or wearing off effect. if you want to try to heal, consider alternatively Sodium Ascorbate (SA) IV or orally at high doses (up to 250 gr/day for 5+10+5 days) to get rid of the yeast that may be causing PD and heal your gut from any kind of disbiosys. SA also boosts dopamine production and nutrient absorbtion from food. Than stay on 50/100 gr/day until symptoms decrease or disappear. In addition add vit B6 (from a B complex) at high doses (50/100 mg/day orally or IM every 3 days) to promote dopamine production and neurotransmitters balance. Add also vit D and mineralize your body duly and remove all the carbs and sugars that you can. If in real difficulty at the beginning of the disease, consider talking with your doctor to take deprenyl up to 10mg/day and add fermented foods in right quantity (you have to test what works best for you). fermented foods brings more tyramin (a descendant of tyrosine, that is well neutralized by the liver if not blocked by deprenyl) it stimulates the production of noradrenaline that helps you to move and lasts longer than levodopa. Deprenyl has side effects on blood pressure and heart rate, so pls do not exagerate with fermented foods. Obviosly you can believe it or not, but I'm ready to provide supporting docs/links

[@AndrewReevesNeurology]

I start them when symptoms get to the point that the person wants to take medicine for them. There used to be a belief that starting levodopa early in the disease accelerates the course of the disease. That turned out not to really be the case.

[@obsoleteprofessor2034]

I am caring for my partner now for 10 years. She went from minor left hand shaking to full body freezing. I can attest to the empty stomach problem. Taking the pils on a full stomach blows the dose. At this time, 2- 25/100 tablets are almost too much every 2 hours because 2 tablets makes her giddy and she is not able to reason through small tasks. When she comes down, she loses mobility but becomes mentally clear. We've tried 1-1/2 tablets every 2 hours but it appears to be slightly short of what is needed because she never really gets full movement. 1-1/2 pills with a full pill one hour to hour and half seems to keep her on an even keel longer. She would get "on" dyskenisia a few minutes of taking pills. She is now getting "off" dyskenisia a few minutes before she freezes up, so it is a sign to give her one pill and then adjust later doses. I give her extended release with one regular release at bedtime so she can go to the bathroom easier (usually attended by me). I give her a full regular pill if I see her jaws chatter when going to the bathroom at night. The empty stomach 7am dose will take effect sometimes as fast as ten minutes. Breakfast follows one hour after, but not too late because it interferes with the next dose. Stress will also shorten the dose.

[@teresakelley4463]

Try lots and lots of water in case he is dehydrated along with the other symptoms. I hope this helps. May have to keep increasing meds slowly to see how they respond to it but the extended release at bed time helped my husband along with the other meds in the day time but if he doesn't drink alot if water he has memory problems bad in the evening. I hope this helps.

[@obsoleteprofessor2034]

@@teresakelley4463 Thank you!

[@AndrewReevesNeurology]

I have had a few patients who sip Sinemet water. The pills dissolve fairly easily and the people kind of sip their way through the day sometimes. Other times they use Sinemet water as a way to take 1/4 or 1/3 of a pill, or some other fraction that isn't 1/2. Just an idea I've seen.

[@maria17690]

Thank you, I really liked this video.. it helped me alot.

[@AndrewReevesNeurology]

Glad it was useful, Maria.

[@gillianfisher3440]

maria1707 QAseeparkinsons

[@johnbottini5203]

maria1707 / ;

[@848bbc]

maria1707 hhhhhh.

[@jackietaylor6006]

Thank you, very informative, I can't understand why my Neurologist said to take sinemet with or just after food, which I've been doing but it makes sense to take it before as protein can be avoided then. My only worry is what will it do if anything to my stomach?

[@georgespeller2632]

Very simple to follow and understand…how do you spread it throughout day if not too be taken Many thanks near bedtime is 8am 1pm 6 pm ok?

[@grahamheywood4426]

Thank you. This was so helpful. Polly UK

[@AndrewReevesNeurology]

Glad it was helpful. Stay healthy and active!

[@junegubatan8429]

Doctor,can stroke cause parkinsons?

[@ShineMedia1]

Thank you for this video. Can you give your opinion on the "slow release" overnight medication? My father is prescribed 10/50mg 4 times a day, but 50/200mg slow release last thing at night and first thing in the morning, which i think is too much. Thee, however, are his "favourite" ones (i asked him). Is sinamet addictive? Im slightly worried about the whole prescription as i feel doctors guess a it too much with this medication. Thanks for your reply, which i understand is only your opinion and not medical advice 🙏

[@andyreevesarchive528]

In the US there are two forms of time release carbidopa/levodopa: Sinemet CR and Rytary. They are not at all equivalent. Studies show that Sinemet CR is barely any different from regular carb/levo in terms of changes in drug level in the bloodstream. Rytary is clearly a more slow time release and a better formulation in my opinion (note: I don't own stock in either drug company!) The milligrams will be higher with a good time release medicine because it is spread out over time. The most important thing is how the medicine works for someone. Don't focus on the number of milligrams; focus on how it affects your father.

[@14thetruth]

Thank you for this very practical presentation, it is very helpful

[@debbieheim3694]

Thank you so much👏👏very helpful

[@westondee-hageman8147]

Thank you

[@GoProGoalieUzi]

Well I’m to 12 sinimet per day. Then 2 more around 4am because I’m too stiff and can’t move in the bed. I also experience extreme pain in my right arm shoulder blade down to my hand and fingers. As soon as the sinimet wears off the pain begins. No arm swing, pain and tingling..then the left arm starts. Veins pop out on my hand. If I raise my arms, the veins go back to normal like flat…hmmm. No tremors yet. The off time is tough, slow and rigid. Next mds appointment in June

[@cherd.a4601]

My patient has been taking this but with different brand, however, we observed that she has changed a lot. Shes not her normal self, agitated most of the time, restless, irritable. We are skeptical as to whether we continue giving her this medication or not anymore.

[@AB-kw2ux]

Sinemet caused psychosis, in my mother's case. She was on 1x4 OD. In such cases, what is the alternative antiparkinson drug?

[@AndrewReevesNeurology]

There are several alternatives. An experienced neurologist might be helpful in selecting other meds. Of course, every single medicine has potential issues. I often remind my patients that aspirin kills thousands every year. Of course, it saves many, many more people from strokes, heart attacks, and blood clots. But there is ALWAYS a risk. Just like every time you get behind the wheel of a car, there's a risk.

[@ArnelDeGuzman-t1f]

Hm sinemet

[@nathaliecheng4190]

Thank you so much! My Father in law does not like taking his parkinsons medications due to drowsiness as a side effect- does taking it regularly help slow the progression of the disease?

[@AndrewReevesNeurology]

It does not actually slow the progression of the disease. Presently we have no medication that does slow it down. Sinemet helps reduce the symptoms, but the underlying process is not changed, sadly.

[@nathaliecheng4190]

Andrew Reeves Neurology thank you- is there any thing in your professional opinion that you believe helps slow progression?

[@bestmomever1347]

So, Sinemet reduces some symptoms and with it we get new symptoms... It does not make sense.

[@kevinsullivan1885]

Can you drink whiskey on sinemit tablets?

[@sebastianscott5545]

thank you young man , the info helps, but just one thing , when i get up i have to take a heap of tabs for the other meds which have to be taken with food ,,,and by the bay the way I have found that when you get the nausea thing have a glass or more of water works every time, for me,, cheers from Australia

[@AndrewReevesNeurology]

Glad to hear you've got an answer with the glass of water. And glad I'm officially a "young man" still! That's the best thing I've heard in a fair bit!

[@eileenmcmaugh9967]

How to put a quilt cover on a quilt

[@seifuddinkarimjee2705]

Hi I am taking halve dose semtex and seligine every day skipping Sunday I feel weak less strength my hands get bent plus my body what so I do inform

[@seifuddinkarimjee2705]

I don't have strength to walk and I urinate often 11 times a day

[@keitymarley733]

Parkinson disease is a very terrible illness, my Dad suffered from it for 19 years until we finally got a help and a medicine that truly works that helped treat, cure and reversed all his symptoms... My Dad is well again..

[@acoustisongs]

Regarding taking Sinemet before bed...it's very hard to FALL asleep when your tremors are going crazy. That's why I take it 1-1/2 hrs before bed

[@marysankus9602]

appreciated ... looking for the 'right' doctor/neurologist near LA

[@richardchandler3820]

My wife is diagnosed with Parkinsom Syndrome and has been referred to a Parkinson specialist to determine what exact type does she have,so to help her with her symptoms until she can see this specialist which is in 4 months. She gave my wife Carbopa/Lepodova 25/100mg and it made my wife so nauseated and miserable she couldn’t get through but only 2 days of it and stopped. Her neurologist is hard to get in touch with, so I don’t know what to do for my wife. Any suggestions please!

[@andyreevesarchive528]

Often I recommend taking more carbidopa with the carb/levo. A 1/4 ratio of carbidopa to levodopa is enough to prevent nausea for MOST people, but not ALL. There is a pill that is just 25mg of extra carbidopa (marketed as Lodosyn in the US) that often works great. Some of my patients need this, and they take 1 pill of Lodosyn with each Sinemet dose. It used to be inexpensive, but someone apparently got hold of the patent and jacked the price to the sky (may worms invade their colon!) Maybe check with your insurance about coverage? Some of my patients get by with taking the Sinemet with a cracker (no protein to speak of in a saltine) and it helps. Best of luck to you both!

[@richardchandler3820]

@@andyreevesarchive528 Thank you for your quick reply. My wife is struggling she’s been bouncing around with Neurologists because they can’t determine what exact type of Parkinson’s does she have. She will see a Parkinson Specialist but that’s not until June 27th. The DatScan said my wife has Parkinisom Syndrome,we have no idea what it is until we see her Specialist. My wife needs help with some relief I will look into this medication you suggested. Thank you so much for your help and time.

[@videomanic411]

Are there not vitamin drips or blood transfusions or oxygen bars that can help work to strengthen the body? Has anyone ever tried those.

[@richardchandler3820]

@@videomanic411 yes my wife and I have memberships to a IV drip spa. They help but in my wife’s circumstance with her having Young On Set Parkinson’s disease it is just a temporary fix for decreasing her symptoms , most of the time she will get about 2 or 3 IV drips a month and it varies on how much or little it helps.

[@claudegagnon3259]

Unfortunately, my tremors either keep my awake at night or wake me up...,. Which then keeps my unsettled...,

[@abdulhaymohamedmayet8741]

i get stomach and herni a problems with sinemet stomach pains unbearable my neurologist has chznged me to madospar stomach has settled down i also suffer fro m anxiety and depresiion itake 20 mg paxil i await your advise abdulhay mohames mayet

[@Talisman730]

Thanks for the tips.

[@brandonjmitchell638]

If you stop taking Carbidopa Levodopa how long will it take to get out of you're entire system?

[@richardearle4922]

I think it will take approximately one day to drain your system oh any signs of having any of the carbida ladopha of my drugs from your body.. I this is just a best guess on my part as I take these drugs and I know when I miss taking them at a given point in time as my body starts to let me know that it is timed to take my next dose of medications I would think that if you wanted to drain all drugs related to this medication you will probably be told to stop taking them one day in advance... Good luck with your new move into some new form of medications.

[@richardearle4922]

K

[@richardearle4922]

You

[@richardearle4922]

You are

[@richardearle4922]

AnI think it will take one day of not taking any of the carbida ladopha drugs from your body.. I am not a doctor so they could probably give you a better answer ... I am just trying to

[@tariqamin8358]

I'm using Senament/ Senmament extra last five years time a day with Ronirole 2 mg twice a day. After taking these extra body movement increase and I can't control my legs and other part of my body Please advise what i do.

[@bamptonbred]

The only one that works for my dad is Sinemet, other brands have no effect. do you ever find this happens sometimes? Since he's started this Brand he's like a different person

[@HassanShahid915_]

Different person as in better or bad?

[@ArceliOgana]

How to use sinemet

[@bamptonbred]

My father's dosage of co-careldopa of 25mg is currently 2 tablets 6 x a day.. I guess this is a very high dose. but he's in stage 4.. His med seems to have stopped working most of the time.

[@tracygarrett9258]

Can you give me some advice please I have been taking stalevo 125mg for many years and have been prescribed co-careldopa but I am confused as to how to Change over these tablets. Do I just stop and start the new prescribed medication? Can you offer any guidence please .

[@LECOMAYAGUA]

Thanks

[@christinelibre5046]

Doc patient with parkinson taking up gabapentin and long acting type of sinemet is it safe to let them take it without eating i mean empty stomach

[@AndrewReevesNeurology]

Usually it is ok.

[@neverstillmechanic2052]

Are there studies showing the results of taking this medication for a short while and ending up having DBS. ? Or how many medications you are going to have to take , in time , to combat the side effects ??? Is it the disease progressing or is the result of taking these meds causing progression in PD??

[@AndrewReevesNeurology]

DBS is usually most helpful for folks who have dopa-responsive tremor, but have developed problems with on/off fluctuations or with dyskinesias. DBS tends not to help balance, walking (in fact, can make them worse) and it doesn't tend to do so much for folks without dopa-responsive tremor. How many medicines? Generally most folks have used Sinemet and one of the dopamine agonists (pramipexole or ropinirole)

[@jashukhan]

@@AndrewReevesNeurology a

[@RG-hf4et]

My dad has to take a morning thyroid pill all by itself. Then he has his coffee and 1st carbadopa/levodopa pill about a half hour later. It sounds like he has to take the thyroid first, wait, take the parkinson pill, wait again. Is this correct? No one has said take it on an empty stomach or avoid protein.........???

[@hedy_7084]

R G I take my thyroid pill as soon as I wake up. I set my alarm for 530 am to be sure to take it at same time on days where I will be sleeping in. I eat a small meal between 30-60 mins after. I then take my carb/Levo at 8a,2p,8p. I also have to take my vitamin supplements at 10am as to not interfere with my thyroid and carb/levo. Have to set reminders on my watch as I am taking pills every couple of hours it seems. 😑

[@LauraTurner-qx9xb]

I eat nothing after dinner and take my levothyroxine before bed (empty stomach)

[@alberickmendes6472]

These meds won’t reduce the speed of the disease it’s just a temporary fix.

[@AndrewReevesNeurology]

Yes, they don't slow down the underlying processes of degeneration. They are to reduce the symptoms. No one has come up with anything that actually slows down the process yet. We are waiting for something like that!!

[@AmeetDas]

My mother feels shakiness when walking and when stand up from sitting position..but she has no tremor when sit down..she alwas fell down when try to walk..what is her problem...is it Parkinson?

[@AndrewReevesNeurology]

Hard to say without seeing exactly what happens. I certainly would recommend she try to get in to see a neurologist. Falls are a serious problem, and can cause significant injury, or even death, so please have her evaluated.

[@GoProGoalieUzi]

I just turned 41. I have been taking cinemet for 9 months. I’m taking 8 pills per day as of Aug.24 2018. My symptoms were: no arm swing in right arm. Tiny printing. Pain in arm. Dropping shoulder/arm. Finger tap exercise bad. Feet tap not too good either. Started with 4 pills then doubled. Seems to have helped. Now my right toes seem to move around, and my right thumb?? Seeing a movement disorder clinic on November 1st. Cinemet is supposed to be the best drug. What happens when I get older? What happens when and if I get tremors?

[@AndrewReevesNeurology]

First, I think you're on the right track with seeing a movement disorders specialist. That's probably the most important thing you can do at this point. He/she should be able to give you a better understanding of what your future options might be.

[@GoProGoalieUzi]

Andrew Reeves Neurology same thing...nothing further to say...just to adjust doses as needed...ah well it is what it is :)

[@colette2757]

GoPro Goalie Uzi ✨ It is what it is... You're so right! Sending a cyber hug, as a hug speaks volumes & warmest wishes... ~~~~ ~~~⛵~~~~~~~~~~~~~~~~~~~~🌅

[@GoProGoalieUzi]

Colette Michell thank you my dear!! I’m dropped to 7 pills per days. No tremors yet. Still have some issues. I’m very active as you can see on my channel. I plan on going day by day...saw a movement disorder clinic...nothing really new. I will see the dr. Every 6-9 months.. ✌🏽

[@centralcoastcamper9631]

The Sinemet currently works well for me. 1-1/2 tabs 4 times a day. Diagnosed 2 years ago when I was 54.

[@GoProGoalieUzi]

CentralCoastCamper I’m 41, taking 8 pills per day!! I don’t have any tremors. Only beginning symptoms!?

[@marylamm5543]

George w bush

[@darkmoon6829]

I've had parkinsons symptoms which gradually changed my walking gait .shaking tremor/action and internal. I was given sinemet to see if it improved my symptoms .it was effective straight away after three in a day by day 3 I was different person .fantastic result which j wadnt expecting. Any way I saw a mds who then told me I've probably I've had a placebo effect 😢. All my symptoms had gone I was tremor free and walking so much better. The MDS then said I had to wran back off it before heceiukd see me again. After two weeks of being off it completely my symptoms were right back to how it was.walking difficulties tremors internal/action .back to the see the MDS and if the hives me one exam even tho I had shuffling gait. I passed the finger thumb test and that was it. Now he wants me to have a dat scan .I feel messed around and not taken seriously. And now left to suffer till then. I need help Does sinemet work straight away Does it mean I cant take it while jm waiting for a DST scan. 😢😢 I'm 45 this month .I have clear symptoms but no evidence when 8 see a neurologist, /mds. But the sinemet worked for me

[@bardez1963]

Susan, At outset I must mention I am not a Neurologist. I was diagnosed with early signs of Parkinsons Disease 5 years ago. I saw two Neurologists to make sure the Diagnosis was right. I have been taking Sinemet 25-100 and it works well most of time. It takes about 30 minutes for the med to start working, so you have to keep that in mind I suggest you see a good Neurologist, it seems you have Parkinsons, and you shouldnt suffer waiting for an MDs diagnosis

[@tanushensivan2454]

Madopar vs sinemet which is better for parkinson disease

[@videomanic411]

Has anyone ever noticed symptoms accelerate with meditation ? We know a few people that seemed to get worse very fast after taking medication. Has anyone heard of this?

[@jojones5820]

I have beem diagnosed with a Parkinsonian syndrome.corticobasal degeneration Is there any thing which would he help

[@AndrewReevesNeurology]

CBGD is a difficult disease to manage. We often try the different Parkinson's medications, to varying degrees of success. And currently we have no proven way to slow down the progression, sadly.

[@joeandamyaleo]

What are thoughts on this information? Levodopa, Parkinson's Disease, and Dyskinesia: The Benefits of Levodopa May Not Outweigh the Risk The majority of Parkinson’s patients treated with Levodopa experience relief from the major motor effects of Parkinson’s. However, according to a recent article in Biospace, after prolonged use of Levodopa (L-Dopa) dyskinesia occurs in ninety-five percent of these patients. There have also been occasional reports of Levodopa side effects after days or months of treatment.

[@AndrewReevesNeurology]

Some large studies have looked at this, as I recall, and there seems to be a pretty minor difference in the rate or severity of dyskinesias. That comes at the cost of foregoing the motor improvements for the preceding years. There are always tradeoffs.

[@joeandamyaleo]

From a neurologist in Spain. It seems like MP is a better choice and it’s natural!! What is your research on MP? Mucuna does not produce dyskinesia. A different study, this time in monkeys (with unilateral parkinsonism induced experimentally), produced very interesting results on the possibility of dyskinesias. One group was treated with Sinemet (levodopa and carbidopa), another with Mucuna plus carbidopa, and the third only with Mucuna. All the animals experienced an improvement in their symptoms. Dyskinesia was then assessed by the study of spontaneous activity in the substantia nigra. Larger dyskinesia appeared in the Sinemet group. In those treated with the combination of Mucuna and carbidopa, dyskinesia seemed more moderate. Interestingly, in those who had only taken Mucuna, no dyskinesia was found [35]. Mucuna and Parkinson’s Disease: Treatment with Natural Levodopa By Rafael González Maldonado

[@ColonelFredPuntridge]

Did you say the carbidopa's role is to prevent the levodopa from making you want to throw up? That's not what they taught me! Yes, the carbidopa prevents nausea and vomiting, but that is not its main purpose, which is: carbidopa inhibits an enzyme in the bloodstream, which would otherwise destroy the levodopa in the bloodstream, before it (the levodopa) crosses the blood-brain-barrier into the brain where it can be converted to dopamine. In other words, without the carbidopa, most of the levodopa will be destroyed in the bloodstream before it can get to the brain and do any good.

[@AndrewReevesNeurology]

Carbidopa inhibits DDC (dopa decarboxylase) and prevents conversion of L-dopa to dopamine in the body. If L-dopa is given alone, there is a lot of nausea due to local dopamine action outside the CNS. Although carbidopa does increase the amount of L-dopa available to cross into the brain, the primary purpose is to reduce/eliminate nausea from dopamine peripherally (otherwise, just giving more L-dopa would be the obvious solution to peripheral metabolism). This effect is why carbidopa/levodopa got its US trade name: Sinemet (sin="without" and emet="emesis...or throwing up")

[@ColonelFredPuntridge]

Thank you. The etymology of the name is particularly fascinating!

[@jimbyroad2113]

Andrew Reeves Neurology aq

[@saraivatoledo1842]

@@ColonelFredPuntridge it is , innit ? Haha .

[@ColonelFredPuntridge]

@@saraivatoledo1842 As it turns out, it's both.

[@jandeeyap9534]

But i cant sleep at night im taking 125mg evry 4hrs

[@teresakelley4463]

Good information but weird at the end

[@gingerjones6436]

You stated no tremors when you sleep. I have tremors during the night in & out of sleep. Is that normal?

[@AndrewReevesNeurology]

Tremors do go away during sleep. They may come back very early in the waking up process, before the person is fully awake and making memories, so the person feels like the were tremoring in their sleep.

[@gingerjones6436]

Andrew Reeves Neurology thanks for the reply. My left arm aches just about all the time, as it pronates and supinates especially. I find myself having to constantly move it for relief. Is that part of my PD too?

[@Joe-gu6oe]

I take 5 x 25/100 carbidopa/levodopa 5 x/dy. It works for tremor however, I am woozy most of my days.

[@krishnanramaswamy9024]

How about taking with mixed in water and drinking it throughout the day. Your daily intake of water will increase and also a steady flow of carbidopa/levodopa in your system.

[@AndrewReevesNeurology]

Yes, that works. I've had a few patients who have used/tried that approach. They have sometimes found it a bit difficult to get a steady stream of Sinemet into their system, but if done right, it works.

[@gerhardkoekemoer9331]

I am using Sinimet 25\100 once every 3hours and then Sinimet CR at 10pm just before going to sleep. I have also found that half a Zolnox / Stilnox can make a huge difrence during the day when I need to work on the computer or need to see a customer. No tremors for between 2-4 hours. Can you explain the reason for this.

[@iqbalghazanfar254]

Thanks u 77

[@katylozano2952]

puede hacerlo en español

[@AndrewReevesNeurology]

Lo siento, pero mi español no es muy bien. Pero puedo hacerlo en japonés....quizas no es muy utîl....

[@gitanjalichatterjee4427]

where to get shinemet650 tablet in India, give the name of the shop Gitanjali chatterjee. India

[@saraivatoledo1842]

@@AndrewReevesNeurology Hhahahah

[@taj935]

I m 34. I hv tremor in my left hand. All the tests were ok but still doctors thnk im Hving perkinson. I use propranol 10 mg and 4 times sinemit half half tablets. I still feel not well with ths. Plz guide me Respect from Afghanistan Jalalabad

[@cocktailn4150]

Could be essential tremors passing into parkinsonism. You can try metazepine

[@gissie391]

I cant get it over counter and was ovwrdosed with dopamine inhibitors onnsome elses medication and never been psychotic or prescribed medication i take leva dopa bit its foid suppliment it helps with the parkinsonions and forward stooping.ok half hour but we need amino acids if i dont take em my heart gets bsd now its ok i take hawthorn and stopped amino acids.i cant get up i dont have parkinsons but sometimes as result of this antiosychotics (unecessary i do.its now 4years it seems progressibe but if i stop leca dopa i dont thinknit will return ?)im not prescribed sinemet id like just short time as i do not beleive dopamine has psychosis effect i certainly didnt have enough any way.i never been psychotic ever in 47 years one cant prescribe antipsychotics hust in case cause in generdl its a existing priblem i specifically have to have it i dont they can do this just in case.i never been psychotic not ince in 47yars ever.

[@Cheryl-or9uk]

I do, but still get sick!!@@

[@noortariq9149]

How to contact you via email or whatsapp?

[@peterleigh8151]

N

[@jjins835]

Hi my mom has recently been diagnosed as PD and shes been taking 2different medications(madopar and perkin25/100) but all the medication make her symtoms worse like legs are more stiff and she has no energy at all. Also make her hard to sit or stand or lie down. Doctors in my country tells her to keep on taking the medication in order to adapt to the medication even though shes having very very hard time whenever she takes the medication. Do you agree? Im kind of desperate seeing her suffering. She has only right leg tremor and rigidity and stiffness but no tremor in her right hand. should she take sinemet? My country doctor said mardopa is the best then perkin and never recommended sinemet.. Thank you so much for reading.

[@gerrimontana8562]

😮0

[@Ashplayz9]

S

[@susannehoulemine883]

I take 15 pills simette

[@Birdylockso]

Does it say "25/250" or "25/100" on your prescription label? 15 pill dosage seems high, but some doctors believe that many are "under dosed" with Sinemet...

[@anndolan8528]

Speech therapy for parkison patients

[@AndrewReevesNeurology]

You're exactly right, Ann! Speech therapy, occupational therapy, physical therapy...all are very important. The LSVT Big and Loud is a good program.

[@simisepulona6634]

Dr. Andrew Reeves neurologist l have lot respect, No Dr. in Honolulu recommended time for take pills Dr. Reeves has Breakfast-Lunch-and-dinner You take this 30-before meal and 90-meal after I like that too. All my kids said “you watch KZbin all the times”

[@bcnbcn1398]

La

[@tessbulatao1650]

Iiiiiii

[@mbear8832]

So many side effects. PD meds are all trial and error as everyone is different too. Cant say much for western medication after seeing my mum on these, but wish everyone on here a smoothe journey.

[@Cheryl-or9uk]

I am sick of this medicine!!!@

[@carol-rk9tq]

another item i found that has been VERY helpful at least fotr me is to take vitamIn C . i TAKE NatuRE Made 1000 mg chewable vitamin C

[@slavicatcoto2660]

Thank you

[@rosemaryclarke6250]

Thank you