TREATING PARKINSON'S WITH CARBODOPA/LEVODOPA,

                        THE MOST IMPORTANT VARIABLE, continued

                                     BY SAMUEL D. MOORE

I found a neurologist that specializes in motion disorders, including PD. My first visit
with him resulted in the addition of 100 mg. of Amantadine per day to my protocol.  

This medication acts as an agonist to smooth out the low spots in the levodopa profile, 

my interpretation. So I am now taking seven tablets of carbodopa/levodopa 25/100 mg., 

one Nue-Pro patch, 4 mg., and one tablet of Amantadine, 100 mg. per day. 

The profiles of the medication are shown in Figure 1. The jagged curve is the levodopa 

profile. The first dose is two tablets, the rest are taken one tablet at a time at two hour 

intervals. The Amantadine is taken one tablet with the first dose of levodopa. The 

dyskinesia is plotted on the lower portion of the graph in % of maximum tolerance. 

 Admittedly, a very subjective parameter. It is on a scale of 0 to 100. Comparing 

Figure 1 to 2, the dyskinesia was more frequent on Figure 1.







Monitoring the dyskinesia is tedious. So I have not done it frequently. The persistent 

occurrance of the symptom after the last dose of the day is obvious. I think it can be 

minimized by a change in timing or magnitude of the Amantadine dose.







I chose a morning dose of Amantadine to minimize the effect it may have on sleep. 

 Before increasing the dose of Amantadine, I think changing the time of day I take 

the medication would be more informative. As shown on the graphs, the Amantadine 

is quickly absorbed and then falls of with a long half life. By changing the time I take 

the dose, I shift the time of the peak concentration of the medication.

Figure 3 shows the effect of shifting the dose time by 10 hours. That would put the 

maximum concentration of Amantadine at the time of the persistant dyskinesia period.





Figure 4 shows the effect of increasing the Amantadine dose by one-half tablet and 

taking the extra one-half dose 10 hours after the first dose. Being able to visualize 

the medication level seems to be a valuable diagnostic tool.