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miracleseeker

Take more or more often with less

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Dr Okun,

You often say it's better to give less and take it more frequently throughout the day.  What about when the doses given each time is not enough?   My mom takes Stalevo 150mg 3 times a day.   She has been on this dosage for years and she can barely stand straight any time of the day now.   Her doctor suggested that she increase the morning dose to the 200mg strength and slowly work it to taking it 3 times a day at that increased dosage.   In this case if she were to decrease but take it more often it would not benefit her since she isn't so much having problems with wearing off too quickly but rather it's not enough per dose for any benefits.

How does anyone know what strength of the medications the patients should be taking?  Does everyone start off at a very low dose and keep moving up?  How long should someone stay at one strength before moving up to the next one when an increase is needed.

 

 

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I would not try to do this alone, but would recommend you find an experienced doctor.

In these cases many people prefer plain sinemet rather than Stalevo, but there is nothing wrong with Stalevo.  Regular sinemet is a little easier to titrate and may have less dyskinesia.

Simply put, your doc should find the amount of time each dose lasts (wears off) and schedule doses to avoid this phenomenon.  Also, you need to work with he/she to find the right dose to turn you to a med on state.

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Sorry if I wasn't clear enough but the 200 mg Stalevo is only the morning dose and the other 2 doses are still at 150 mg.   We are trying to get her used to the increase before giving her the 200 mg at the other 2 doses too.   The drug is not wearing off but rather it doesn't do much for her at the strength of 150 mg.  My mom takes Stalevo crushed and has done it this way for over 5 years now.  She will not swallow medication so this was the only way to have her take it.  Sinemet is far to weak to do anything for her so this is why we have kept her on Stalevo but she takes .50 mg Mirapex it too.  So far she has been walking a little better since this increase from a week ago.   She had dyskinesia from just .25 mg Sinemet  but for now none on the increased dose of Stalevo.  Who knew?

 

 

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I think it is great to find something that works and of course you and your doc can slowly increase the other doses and monitor for benefits and side effects.

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