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Rytary vs. Sinemet ER

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I was taking carbo/levo  25/100 4x a day.  I was experiencing some dyskensia so my  MDS put me on Rytary 36.25mg/145 mg  3 x a day for less dyskensia.  I have been having increased stiffness esp in my neck.   She suggested I bump it up to  48.75/ 195 mg 3x a day.  My primary dr. took me off Fosamax thinking it was causing the stiffness.  But it persists.   Currently my insurance is paying for the Rytary till January.  Would I do okay on Sinemet ER?   My concern is the cost.  Is Rytary similar to Sinemet ER?   Amanadine  was suggested to add with my carbo/levo  to lessen dyskensia so I opted for the Rytary.      

I, also, take Effexor 37.5 mg  1 x a day.   It really blunts my emotions.  Any suggestions on another drug?  It is effective on stabilizing my moods, but I have almost zero emotions.  I have no emotional outlet it seems and it can't be healthy.

Thank you for your help.

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I have heard this happening to other people who switched from Regular Sinemet to Rytary, including myself. I changed the dose of Rytary over a matter of 3 months with no relief in symptoms. It was at that point that my Dr. and I tried Sinemet ER and we have not looked back. Rytary has worked great for so many people, but there are some that did not get a smooth transition without relief of symptoms or symptoms getting worse.

My advice would be to try to transition to the Sinemet CR now, so you can see if it works for you. The Sinemet CR comes in 2 strengths, CR 25/100 and CR 50/200. As I always say, it is best to "start low and go slow" when starting a new medication. The Dr. may start you off with the CR 25/100, which can be taken anywhere from one to three times a day. You may probably notice a difference in symptoms anywhere from 3 to 5 days or up to 1 month at the longest.

As far as an antidepressant, Effexor is in the class of antidepressants known as SSNRI's (Selective Serotonin Norepinephrine Reuptake Inhibitor), which works on 2 different neuroreceptors. A change in class may help with feelings of emotion. A possible change to a SSRI (Selective Serotonin Reuptake Inhibitor) only works on one neuroreceptor.  Out of this class I have seen Lexapro used quite effectively in Parkinson related depression. Other choices may be Zoloft, Paxil, and Celexa.

I hope this helps and please keep me posted.

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