Monthly Archives: March 2013

How do I best time doses of carbidopa/Ldopa?

Medication Assistance is availableThe following excerpt is from a question received by NWPF.

We were told by our neurologist that my husband should take carbidopa/Ldopa (Sinemet) every 5 hours and also told to take it with meals. What is the best way to time the dose of this medicine?
There is no standard way to take carbidopa/ldopa. Dosage truly depends on the person’s symptoms, stage of disease and side effects.  The following situations describe some of the different ways that carbidopa/ldoap can be given:
  • Without food. Protein does delay absorption of this medicine from the intestines.  For this reason you sometimes hear the recommendation to avoid this medicine with food so it can be absorbed faster.
  • With food. This is helpful if disease is mild, a person has no wearing off symptoms, or nausea is a problem. In this case, medicine is often taken with meals for convenience and to minimize side effect.
  • Spread dose out during waking hours. To keep things easy, your doctor can simply tell you to spread out doses during the day (in your case every 5 hours.) This is especially helpful early in disease or if there is no wearing off, dyskinesia or side effect.
  • Specific times given. Timing of doses is also tailored to the individual’s day and night.  If a person wears off at end of dose, has dyskinesia or side effects then medicine is given at more specific times based on these symptoms.
The best thing to do is to talk to your Neurologist about the conflicting guidance you have been given so that you can decide together which one is best for your husband.
See related article to learn more about protein and medicine.

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Filed under Medication Side Effects, Parkinson's Medical therapy, Self-Care

Booth Gardner has touched the lives of so many

boothI learned today that Governor Booth Gardner died yesterday. Governor Gardner was a source of inspiration, creative leader, compassionate man and friend to many. When diagnosed with Parkinson’s, he used this to reach out to others in strength, support,and  kindness. His concern for others proved him to be a man of grace and dignitiy. The following statement is from the members of NWPF as we honor Booth’s memory and share our condolences with family. Please celebrate Booth’s life by replying to this statement with your message of  appreciate for Booth.  Monique Giroux, MD

Northwest Parkinson’s Foundation

Statement on the passing of Governor Booth Gardner

The Board, staff and supporters of the Northwest Parkinson’s Foundation are deeply saddened by the passing of Governor Gardner.  Booth was a leading voice for the Parkinson’s community throughout the state and the entire country.   As a long-time Board member, NWPF is indebted to him for his tremendous contributions toward raising general awareness of Parkinson’s Disease and pushing for greater access to patient care and wellness.  His legacy will endure through his work in establishing the Booth Gardner Parkinson’s Care Center.

The Northwest Parkinson’s Foundation sends its condolences to his family.


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My mom has PD and almost every evening, any time between 4-8 pm she experiences hot flashes, she gets really red and hot from the neck up, while the rest of her body is cold. Is this a PD symptom? We have to put ice packs and iced towels all over her head and face to get it to calm down.

Autonomic nervous system influences blood vesselsThere are many causes of hot flashes including hormonal changes in women, anxiety, medicine side effects and certain medical conditions. Alterations in perception of temperature can be seen with advanced Parkinson’s disease. It is thought, in part that these symptoms can be caused by an alteration in the autonomic nervous system. This branch of the nervous system can control how our blood vessels constrict or dilate – altering blood pressure, blood flow and temperature. Drenching sweats and redness of skin can be associated with motor off periods when medication dosing and effect is low (often seen at end of dose) or the alternative situation when medicine is at its peak (often associated with dyskinesia or too much medicine.) Off related problems are often experience with sweating a condition called, off-related drenching sweats.

Continue to track the timing of the symptoms, along with the time medicine for Parkinson’s is taken and whether movement symptoms are well controlled. This will help your neurologist determine if there is a relationship between these variables especially if symptoms are noted after a dose is taken or just prior to the next dose. With this added information, your neurologist and primary care provider can help you determine the cause.


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Filed under Parkinson's Medical therapy, Symptoms, Diagnosis and Progression