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About Marketfocus

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  1. I'm wondering about a gradual transition to Rytary from IR Sinemet, maybe one dose at a time versus a complete switch in one day. It seems that different doctors have different opinions on this matter. I have a difficult time adjusting to new medications and would feel more comfortable taking a very gradual transition approach rather than switching all at once according to the conversion chart (which seems to be best guess and would need some adjustment anyway). also, I was given some Rytary samples which expired in July. Are these still good or have they likely lost effectiveness? If I'm going to finally try this medication I'd like to at least make sure the trial is with samples that are still effective. Thank you very much!
  2. Rytary transition

    I'm interested in trying Rytary because I'm really not getting a good response from regular immediate release Sinemet. I'm wondering if there is a standard protocol for making the transition - my current MDS is recommending making the switch all at once (in one day) from Sinemet to the best guess daily dose of Rytary. Yet a previous Doctor thought it would be okay to change one dose at a time - I've also spoken with other PwP who successfully made a very gradual transition to Rytary. I have a very difficult time adjusting to new medications and would feel much more comfortable with a very slow and gradual transition process. Is this appropriate for a switch to Rytary, and if so, what might a general transition approach look like? Finally I have been given Rytary samples which expired a few months ago, in July. Are they still okay to use? (Seems like it would be better to use unexpired samples, particularly starting out, but maybe there is more latitude in the date when they lose effectiveness . . .?) Than you very much!
  3. Meclizine

    I'm wondering if Meclizine can be taken safely by PwP? A former neurologist suggested it might be helpful with the dizziness/vertigo I experience with migraines. Does it interact with Sinemet or is it otherwise contraindicated for persons with Parkinson's ? I have also read meclizine could potentially be neuroprotective. Is there any evidence to support that ? Thank you
  4. I've recently read that doxycycline might have some benefit in interfering with alpha synuclean clumping. Having been recently diagnosed with SIBO and the GI Doctor is recommending treatment with antibiotics (xifaxan), I'm wondering if doxycycline might also treat SIBO and be an alternative antibiotic treatment with other potential (although I realize unproven) PD benefits. Thank you.
  5. I've recently been diagnosed with small intestinal bacterial overgrowth (SIBO) and am wondering if this impairs Sinemet absorption? Also how is this best treated? With antibiotics, probiotics or diet? I've recently read that doxycycline may have some benefit to PD in terms of interfering with alpha synuclean clumping. Will doxycycline treat SIBO? I thought if it could treat SIBO and potentially have these other benefits,. It might be a good choice. Thank you.
  6. Does small intestinal bacteria overgrowth (SIBO) interferes with Sinemet absorption? Also how is this condition treated ? Are the effects similar to H pylori which I understand can impair the effectiveness of Sinemet? As always, thank you very much for your help!
  7. More informabout Xadago (safinamide)

    Thank you so much for your informative and thorough reply about how Xadago works! I appreciate your taking so much time to provide so much detail- this will be of great assistance as I evaluate how to proceed. Thanks
  8. More informabout Xadago (safinamide)

    How does the mechanism of action of Xadago compare to how Azilect works? Does Azilect modulate glutamate release as well or does it work some other way? One reason I'm wondering is that I was unable to take Azilect as it aggravated my migraines. However, I do take topamax for migraines which I thought affected/calmed down glutamate in some way. So I'm hoping I may be able to tolerate this new drug if the mechanism of action modulates glutamate and therefore might not aggravate my migraines. (The chemistry is really over my head but I sure would like another option!). Thank you!
  9. Xadago

    How does the recently approved new drug Xadago compare with other MAO-B inhibitors such as Azilect? Thank you.
  10. Sinemet IR and CR

    I'm working with my doctor to switch from taking all Sinemet IR during the day to a combination of IR and CR in order to hopefully get more on time. If I'm switching a dose that was formerly e.g. 1.5 or 2 tablets of 25/100 IR to a combination of IR and CR, would it be better to take one tablet of the IR and then wait an hour before taking the CR tablet, or is it fine/better to just take them together? Also I was generally waiting 3.5 to 4 hours between doses while on all IR Sinemet. How should the timing between doses be adjusted with this combination of IR and CR? Thank you very much!
  11. CR vs IR and eating

    I seem to remember you mentioning taking Rytary in the past. In your experience, how does the Rytary compare to the regimen you just mentioned with the combination of Sinemet IR and ER in terms of effectiveness and side effects? It seems I've heard more favorable comments about using ER and many comments about difficulty getting the Rytary dose right. I'd appreciate your perspective on this. Many thanks!
  12. CR vs IR and eating

    I am wondering about making the change from Sinemet IR only during the day to a combination of CR and IR. I currently take CR only in the evening and I seem to get a better response than from the IR, particularly after meals. It sounds like on this forum that many people take CR through out the day, possibly in combination with IR with good results. When I've brought this up to my doctor in the past, she made it sound like it was too hard to predict/control the effects of CR with continuous use through the day. As I have considerable off time with some dyskinesia with the current regimen of IR only during the day, I'd like to try something different. We've also discussed Rytary but it seems that might be even trickier to switch to. I'd appreciate your thoughts on this. Also, on a related issue, I'm wondering how it works when people take a low dose of Sinemet every two hours as far as food intake. If it's best to wait a period of time before and after dosing to eat, how does this frequent dosing work with meals? Thanks!
  13. Timing of Sinemet vs increased dose

    I'm wondering about balancing increased Sinemet dose with increasing dyskinesia, while dose still doesn't really seem to kick in. I feel I am really under medicated but as I've gradually increased my immediate release Sinemet 25/100 from 1 to 1.5 pills per dose to current level of 1.5, 2 pills , and 1.5 - 3.5 hours apart plus 1 CR in the evening, I can't say I notice that much on time (even when I take the 2 pills mid-day. ) My goal was to increase to 2 pills 3 x per day plus CR in the evening but as I've already noticed some increased dyskinesia without much if any improvement in symptoms when I take 2 Sinemet, I've been reluctant to increase the dose . I also have extensive bloating late in the day (gone by next morning), so I'm wondering if there could be a gastric emptying issue. Also, based on other comments posted, wondering if using CR throughout the day possibly might be more effective . Thanks.
  14. Lately I'm having a very difficult time getting much if any "on " time with my Sinemet - currently 25/100 IR 1.5 tablets AM, 2 tablets about noon, 1.5 tablets mid afternoon and one CR in evening . I take c/l at least an hour before or after food, and in the morning, this is after not eating all night. I do however have a fairly high protein diet due to reactive hypoglycemia. The one time I seem to get a better response is on occasions when I take 10 mg propranolol the night before. The next day rigidity and slowness of movement are significantly better (25-50 pct improvement) than when I take the c/l alone. I've described this to at least two MDS doctors and they can't explain it other than to say perhaps my autonomous nervous system has been calmed down a bit. I can't take the propranolol daily as it causes depression if I take it more than a few times a week. I've tried increasing my Sinemet but it seems I am getting some dyskinesia so I've backed off that at this point. I've tried Azilect and entacapone and both caused migraines. I have a history of OCD and have been advised not to try dopamine agonists. So that pretty much leaves me with trying to get the c/l to work better . I've also reas lately h pylori can interfere with Sinemet absorption. Any thoughts you might have in improving the Sinemet response and reasons for the benefit with propranolol would be appreciated. Thank you!
  15. Antidepressants and migraines

    Which antidepressants are least likely to aggravate migraines and can be taken in combination with topamax? I tried sertraline and immediately had migraines for the next week. Seems like I read venlafaxine was sometimes used to treat migraines so I'm wondering if that or one of the other antidepressants might be a better option. Thank you.