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The Pharmacist's Forum>
"Please post all your medication questions here"
Biphasic dyskinesia.
SueC
2 posts Jan 29, 2010
9:27 AM
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SueC
3 posts Jan 29, 2010
9:40 AM
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I experience what I think are biphasic dyskinesia with every dose of sinemet and amantadine that I take. At the trough, I have tremor, bradykinesia, etc, then 20 minutes after taking my meds, I experience high amplitude involuntary choreaform-type movements, then therapeutic effect for approx 90min, then dykinesia on the way back down, then back to tremor. My neuro MD increased the frequency of my doses to every 3 hours, but I still have this pattern. I've tried lowering my dose and then all I experience is dyskinesia for 2 1/2 hours, no therapeutic effect, With my regular dose ( sinemt 25/100 immediate + 25/100CR + 100mg amantadine), the dyskinesia increase in intensity as the day progresses. I also take Requip 4mg XL, 50/200CR of sinemet and clonazepam 0.5mg at bedtime. I wake up with tremors during the night as well as low grade dyskinesias prior to the tremors about 3-4 hours after falling asleep. My idea is if the Neupro patch ever comes back on the market, I could keep a steady level above the therapeutic threshold which apparently is higher than my threshold for dyskinesia. It may work, but do you have any other suggestions for the biphasic dyskinesia. I've tried increasing my Requip XL to 6mg, but I experience major regression in my balance.
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brooksie
349 posts Jan 29, 2010
5:09 PM
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SueC, Mark, of course, will have more concrete answers, but I do want to say that this sounds like hell!. I wonder if you might look a little more closely at the CR? I take it and it immensely helps in smoothing out the peaks and troughs, but I have read that some people using it may actually experience more dyskinesia? I also question that every 3 hours is enough for you? Many of us halve our dosages and take more frequently. The best way to avoid dyskinesia, is to have as steady a low dose as possible of Sinemet in your system at any given time. Given that, you may need to lower the dose and increase the frequency you take meds, if at all possible. On days I work, I use the CR as my main drug but keep it going with 1/2 tab of the regular Sinemet every 2 hours. See this thread for other variations on this theme: http://neurotalk.psychcentral.com/showthread.php?p=115851 Another possibility that works for many is to dissolve your Sinement in a blend of OJ and water; a liquid suspension, and sip throughout the day. I am not at all sure of ratio (number of Sinemet to liquid), but I think Mark knows of this. Hope you find some relief very soon! Laura
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ThePharmacist
513 posts Feb 01, 2010
6:24 AM
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sue, I would really like to look at this closely and see what exactly the issue may be. This is the info I would like from you. It is like a day in the life of sue. Below is the info I need to give me a little more insight. 1- An exact list of your meds and long have you been on them ( don't need to know at what times you take them...yet). 2- What meds have you tried that did or did not work. 3- A 3 day diary. I would like to know the following for each day and be very specific. What time you get up in the morning. What you have to eat and at what times. Also include snacks etc. What meds and what times you take them. What activity and at what time and for how long. Nap time. Shan and for how long. Basically, I would like an exact account of your day for 3 straight days. Write everything down, even if it does not seem that important. This will give me insight to see if other factors may be at play. Please leave you email address, and I will send you mine, so we can discuss this without the world knowing your every move. I really want to help you and hope I can. Best of health, Mark
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simplysue
31 posts Feb 01, 2010
9:28 PM
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Hey, Sue C. and Mark! Can you keep us posted on how things go with figuring out your meds? You could be me and I sure know what you are going through! And Laura, I always appreciate your kind, sensible, knowledgeable replies! Keep 'em coming! Sue, too.
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sunflower4u
6 posts Feb 02, 2010
7:44 AM
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Me too! You could have written my med experience as well! Thanks. Sunflower
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ThePharmacist
516 posts Feb 07, 2010
9:51 PM
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will do. Best of health, Mark
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