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Sinemet & Dementia with Lewy Bodies

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I have a solid diagnosis of DLB mixed with Alzheimer's. I'm 66 and 185 pounds, male. I got my diagnosis at a major medical center's memory assessment clinic, but I am seeing a local neurologist for management of medications that were recommended by the center. I'm on Exelon, Celexa, and a bunch of other stuff and some heart medications for stable heart failure. I started Sinemet one-half 25/100 3 times per day a week ago with no problems. My neurologist told my wife (a doctor) to move me on up to one full pill of 25/100 3 time per day. If all goes well, what is the normal next step up. I'm taking these for the Parkinsonian movement, muscle, stiffness, pain stuff. Just trying to get an idea, as my wife won't tell me anything other than see the neuro and go the PT. I'm set to see the neuro in two months, but he will discuss med adjustments with my wife along the way based on what I told my wife. This is a little different I know, but that is kind of how it works where we live. Thanks for any information. I realize you only can make generalized comments and nothing specific for my case.

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Thanks for the information and the question. What you should expect with Sinemet, as well as most medications for Parkinson's Disease, is that one will start off at a standard dose and that dose will be increased if need at small increments over a period of time. This dosing regime is what I like to call the "Start low and go slow" regime. Small increases in dose of Parkinson's medication can make a big difference because we are dealing with brain chemistry. Increasing a medication too high or too fast can have severe consequences.


In your situation you started at 1/2 tablet and then increased to one tablet. The next step would probably be 1 & 1/2 tablets 3 times per day unless you are having issues at a certain time of the day. For example, if you start having difficulty managing symptoms in the morning there would be no reason to increase all of your doses throughout the day. Instead, it would be reasonable to target the dose at that time of the day and increase that a small amount. No matter if it one of the doses in the day or all of the doses in the day that need to be increased, all of those individual doses should adhere to the "Start low and go slow" philosophy.


I hope this helps and please keep me posted. Good luck. 

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