I saw my consultant yesterday, and she suggested that I try a low dosage of Sinemet (carbidopa-levadopa) on an “as required” basis. This is an approach that I haven’t come across before, but the way that she presented it made a lot of sense.
Apparently, I have been labouring under a misapprehension, viz. that levadopa “only works for 10 years”. Current medical thinking is that it works for as long as it works (this makes more sense, scientifically), and that its efficacy is dependent on the patient’s dopamine deficit, not on when the patient started to take it. My dopamine levels will inevitably decrease, and – side effects aside – it seems pointless to carry on undermedicated.
If, indeed, I am undermedicated.
I think that the chances are that I am, but we talked about my dystonia (still the most annoying symptom), and there are, it seems, two ways in which dystonia can manifest in Parkinson’s.
- It can be a symptom of Parkinson’s itself, and so occur when you are undermedicated
- It can be a side effect of the drugs, and so occur when you are overmedicated
If you are taking a controlled release drug (like my once-a-day ropinirole), it can be difficult to work out which scenario is yours. However, if I add an on-demand Sinemet, I should be able to tell if my dystonia gets better or worse shortly after taking the tablet, and that will allow me to determine which situation I’m in.
I will be seeing my GP soon to get a prescription for Sinemet as recommended by the consultant. It’s almost certainly the first step in what is sure to be a long process of switching drugs from Ropinirole to Sinemet.
You may be wondering about the illustration. It’s nice to have a picture, but the subject didn’t suggest one, so I used my current “work in progress” – a really big canvas featuring a panoramic view – which I was working on yesterday before heading off to the hospital. You can read about the painting on my art blog.