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Decreasing Diphasic Dyskinesia

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Over the last several months the diphasic dyskinesia has gotten worse making it extremely difficult to walk. The walking issues disappear when the medication wears off.

I was taking CL 25/100 1 tab 4x/day. My on time would be approximately 2 hrs per dose. Recently, my MDS suggested trying the extended release version in addition to the immediate release. I've been taking 25/100 ER twice a day as well as half a regular CL as needed about 2x a day. I have been struggling to find a schedule that will work especially when I add eating to the mix. Some days the dyskinesia lasts 2-3 hours without me fully being "on" to start. The upper half of my body will feel "on", but my lower half will not. Could it be that I need more CL to push me over the dyskinesia threshold? Occasionally, I will only have dyskinesia in the morning as the medication is kicking in. Also notice that the last dose just wears off without any dyskinesia. Why? Is it because of the amount of protein I eat at that time? It is not consistent. Should I be taking 2 ER tabs per dose or the 50/200 instead? I'm trying to keep the medication to a minimum because I don't want the dyskinesia to get worse and also feel more off balance.
I just picked up my Rx for Amantadine, but have not started it yet. What time of day is best to take it and is it better to take it together or separate from the CL? 
Help! Thank you for your time.

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I think you need to start  journal about PD. The journal should contain the medication, strength, time you take it, and any untoward effects (ie, Dyskensia.)

I will tell you that when you first start changing

My first recommendation would be to take a short acting (immediate release) as soon as you wake up. Mark that time in your journal. That way it can be absorbed and kick in to start working. Now, when you start to feel off, take the CR and mark it in the journal. Now when you feel like you are going off, take a Regular Release  Sinmet and mark it in your journal, wait about 30 minutes, then take an Amantadine and mark it in your journal. The next time you feel off, take a Regular Release Sinemet, and mark it in your journal Then the next time yo feel off, take a Sinemet CR and mark it in your journal. Then the next time you feel off, take a Sinemet Regular Release and mark it in your journal. Then the next time you feel off, take a Sinemet Regular Release and mark it in your journal, then wait 30 minutes the take an Amantadine, then mark it in your journal. From there, if you feel off again, you should take a Sinemet Regular Release and mark it in your journal.

The example journal should look like this:

Medication                 Strength          Time Taken          Result

Sinemet Regular          25/100             7:00am               Off at 8:30am

Sinemet                        CR                      8:30am               Off at noon

Sinemet                        25/100             12:00pm             

Amantadine                   100mg            12:30pm             Off at 2:30pm

And so on.

as you noticed I have you make sure that you write in the journal the time you went off. This is so that when you take the medication tomorrow, you should take it about 30 minutes before the time you did yesterday so you can avoid the off times. If you keep up with this journal, after about a week, your medication regime should be so effective that you may not even have any dyskensia, or many fewer. How may keep changing the times so that eventually the regime will be perfect, or close to it.

I hope this helps and please keep me posted.


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