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Iam using a combination of rytary, sinemet CR and sinemet for my medication,.

My last dose of the day @ 5:30 has been 1 Sinemet CR, 1.5 reg sinemet and amantadine.  I take rytary during the day but I cant tak it after 3 other wise i keeps me up.

Back in jan the CR Sinemet was not lasting very long so I added 1/2 a CR.so now I was taking 1.5 Sinemrt CR . Back in Jan I  was running out of juice .  I then started

having trouble falling asleep, one I got to sleep  I didnt wake up. I saw a sleep MD who didnt do a study but referred me to an insomnia expert.

I saw her last week and she thinks that I am going to bed too early. ( which I Am)  following 1.5 reg sinamet and 1.5 of the CR i was running out of juice @ 8:30 so I to go to bed.

So I was going to bed too early because I was off.  So I needed to find something that will help me stay up a little longer so that when I go to bed i am going to bed b/c I am tired not b/c my medicine wore off  ..  So in creased my 5:30 Sinement from 1.5 to 2. Well that didnt work b/c I was awake most of the night.  So increasing the CR to help me stay up longer so i can get my sleep schedule straightened out ,is actually ,making  my insomnia worse.

So what I  need is a schedule that will keep me on alittle longer without effecting my sleep. You cant use rytary or sinemet CR since there appears to  be something in the extended fomula that keeps me awake.

So  basically I am  between a rock and a hard place.

 

Would appreciate any ad vice

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Noah,

I have seen this in other patients, including myself, when I tried to switch to Rytary from Sinemet CR and Sinemet combination. What I have learned is that it is not necessarily the contents of the product themselves, but rather the combination and timing of the medications. Some people do well on the switch to Rytary while others do not. I usually recommend that if a person wants to try Rytary that they do it 100%. To solely take Rytary and not mix it with Sinmet CR. When two medications are taken together it is very hard to differentiate which medication is the culprit of the side effects or is it a combination of the two. With this in mind, I usually recommend that a person choose between Rytary or Simenet CR (+) Sinemet.

In order to be able to help manage a medication regime that that may help you in your situation I will need your daily medication regime. I will need Medication, Strength, Extended Release or Immediate, and the Times that you take these medications throughout the day. This way I can get a better look at Dosage and Timing of each medication and make suggestions of any changes that may need to occur.

Thank you and I look forward to helping you.

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Here is med schedule

6:30 :2 Rytary, 1.5 Reg Sinemet,2 Carbidopa 1 amantadine,1 azilect 15 mg paxil

9:30 :3 rytary,1 sinamet,1 carbidopa

12:00 :3 Rytary  1 Sinemet  1 amantadine
1 carbidopa

3:00
2 Rytary, 1.5 sinemet, 1 carbodopa

5:30 
2 sinemet. 1 CR , 1 Amantadine 
1 carbidopa

8:00
2 sinemet

Bedtime
50 mg Nortriptylin
 

My challenge is to stay up late enough to re train my brain.  I have been trying the above for a few days and while sometimes it works 

there are other times it doesnt. Tuesday nite @ 7 wanted  to treat myself with some m&m so i had a small bag well that didnt work . I took my 8:00

sinemet and kit never kicked in. Ok so maybe the m m's were to high in fat so my meds didnt get absorbed.

Last night I had pasta for dinner very little protein and my 8 dose didnt kick in either   Would appreciate all your help!

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It sounds like you are being proactive rather than reactive, which tells me you understand how your body reacts to the medication, Well done Noah! Rytary should be take on an empty stomach, which means one hour prior to a meal or 2 hours after a meal, whether it is protein or not. The perfect environment for the Rytary to be broken down and absorbed is when the stomach is empty. When there is food involved, acids released in the stomach in order to break down the food will be higher than on an empty stomach. This may be why there was a delay in onset of action or the medications might not being available at all because the higher acid content could break down the medication completely, or close to it, which would not allow enough of the medication to get to the small intestine where it is absorbed into the system. When protein is involved, the liver is where the interaction happens.

I hope this helps and jeep me posted.

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Thank you for your help.

My problem is that I have been having trouble falling asleep and it was suggested that i was going to bed too early.  I have been going to bed because i am off.

I need to stay up later so I can retrain my brain but if i stay up i get so off i i can barely move. I tried taking sinemet @8 to stay  on a little longer but it doesnt matter if i take 1,2 or 2.5 sinemet i am still off at 820.

 

Any thoughts?

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Noah,

I would first make sure that the Sinemet is taken 1 hour prior to a meal or 2 hours after a meal. The second idea I have is to try and take the Sinemet earlier in the evening than 8:00pm. I have also had this trouble, on and off- no pun intended) throughout the years. There is no ryme nor reason as to why it happens and I cannot figure it out. I was talking to a therapist friend of mine who made a great point. He stated that me just worrying about the medication working on time may delay the symptom relief. It may appear and look as if I am "off" but it may really be an anxious reaction to me thinking, "Is it going to work?" Of course my first question was, "So, how do I go about not thing if my medication i going to work?" He replied with a grin and we discussed it at length. Some of the suggestions were to get involved in a project that may start about 7:00pm and take me through about 9:00pm. I have many hobbies, such as stained glass working, glass etching, painting, and memory games just to name a few. So I have tried those and it seems to work sometimes. When I brought this up to my Neurologist, he suggested a low dose Anxiolytic (ie. Xanax, Ativan, etc...). I was not a big believer that I need one beacuse I am one of the most laid back people you would probably ever encounter. We agreed to a dose of Xanax 0.25mg to be used once daily IF NEEDED at about 8:00pm. Well I know that the side effect is drowsiness, which is one thing I was trying to avoid. So what I did was take my Sinemet between 7:00pm and 7:30pm, try to engross myself in one of my projects, and if after about 30 to 45 minutes I did not feel like I was getting symptom control I would take the Xanax and continue my project. This worked wonderful. Most days I do not need to take the Xanax because I am so focused on my project. What I need to do was find a hobby or project that takes up a large quantity of time. I have found that putting together a puzzle, doing a HUGE word search, BIG cross word puzzles, or any other project that takes longer than 2 hours to complete is the best, If you choose to do many little or small projects your mind has a tendency to refocus on your medication issue between these small projects.

I hope this helps and please keep me posted on your progress.

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