Why are side effects so unpredictable? - Parkinson's Disease Message Board

Bruce · 11-19-2001, 08:04 PM

MD: I am not seeking medical advice, but wondered if you had any thoughts on this subject.

The last two days I was forced to increase the dose of Sinemet, because when I feel weak, that tells me I am in an off period. The first time I took 1/2 extra Sinemet 25/100, their was no dyskinesia and I felt great. This morning, same dose, same time and I had severe dyskinesia. Later, same dose, the weakness returned. Then this evening, same dose, no weakness or dyskinesia.

I always avoid eating an hour before and after taking pd drugs. It always seems that it is impossible to predict the effects of the drug until after I take it. Something seems to affect how much of the Sinemet is absorbed, and I don't have a clue what it is. It is like being on a roller coaster, going up to high and then to low. Bruce

md1817 · 11-19-2001, 11:08 PM

This is perplexing, but, as I'm sure many would attest, not an uncommon experience.

I just don't know why people experience such unpredictable responses. My hunch is that many factors influence medication response in addition to time of day and food. This is one reason it is so challenging to attempt to devise medication regimens that are effective and realistic.

Pelicangirl · 11-19-2001, 11:43 PM

Hi Bruce,

If I may throw my 2 cents worth in -- and that's about all it's worth -- there are so many things that affect the symptoms of PD other than eating. For instance, there is stress. And I also feel that when I'm active and doing things, it uses up more of the medication. That's just my opinion and maybe my experience and no one else's. Even though I'm only on Requip now, still if I stand for a long time or walk a great distance, my legs start bothering me. Can't exactly say what it is that's "bothering" me, but that's the only way I can describe it.

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Pelicangirl (aka Ruth)

Suzanne · 11-20-2001, 01:54 AM

I also find that stress or extra physical exertion makes meds less effective for me, and when I have to stand or walk more than usual, or I'm upset and stressed-out, my legs get stiff & achey, and my feet get painful spasms. On a calm, peaceful days, my meds work very well, and I even forget for awhile that I have PD.

Bruce · 11-20-2001, 11:45 AM

I agree that stress or anxiety increases the symptoms, because I have been through that for many years, but I was mainly refrring to starting on a new drug or increasing the dose of a drug i am presently taking

For example, when starting a new drug such as Requip, it is recommended that we start on a lower dose and gradually work up to the correct level

My hunch is their must be some adjustments in our body chemistry to get used to the new drug, but the effects are usually the opposite to what seems to be logical.

Today the roller coaster is on the down side, no dyskinesia, no energy, but if I take more Sinemet it might be a big mistake.

Bruce