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Does Elevated Dosage Of Sinemet (Levodopa-Cardopa) Cause Bradykinesia?
Hello Dr. Rynne, just a quick question about my husband who has PD. I am wondering if sometimes increasing the dosage of Sinemet (Levodopa-Cardopa) can cause symptoms it is prescribed to take care of and prevent, such as less awareness, more difficulty in ambulating and/or bradykinesia? I have found that when I return to the original dosage of one qid instead of two qid, he does better in this area. He sees a neurologist and I have told him about this. He still wants the higher dosage. I am an RN, so I know what to look for, and I caregive my husband 24/7 for years now, while the physician sees him for 30 minutes every six months. I told him I am giving him information of my observations. I realize you cannot disagree with an attending physician. Would just like to know if you have seen this before. Thank you very much. My husband is also a Type-1 diabetic, so that is a whole nother story. Deborah, RN
Mon, 30 Apr 2018
Hello,
The phenomenon you are referring to is a common effect of long-term use of Sinemet. It is known as an on-off phenomenon, where the patient is liable to experience bradykinesic episodes and depression.
With respect to your question, it is not the increase in dosage that causes this bradykinesia, but the chronic use. There are a couple of things that can be done to minimize these episodes. For starters, decreasing dietary protein consumption has been shown to minimize this effect.
There are a couple of medicines like Selegiline and Apomorphine that have shown some promise as well. You could ask your neurologist about the same.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Pranav Balakrishnan
The phenomenon you are referring to is a common effect of long-term use of Sinemet. It is known as an on-off phenomenon, where the patient is liable to experience bradykinesic episodes and depression.
With respect to your question, it is not the increase in dosage that causes this bradykinesia, but the chronic use. There are a couple of things that can be done to minimize these episodes. For starters, decreasing dietary protein consumption has been shown to minimize this effect.
There are a couple of medicines like Selegiline and Apomorphine that have shown some promise as well. You could ask your neurologist about the same.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Pranav Balakrishnan
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