A couple of good Parkinson’s related questions today that I wanted to follow up on, which brings up a good reminder to all who follow this page…feel free to ask questions – just drop me an email on the website, or message me on facebook.com/meded101 – I get to as many as I can!

1. How should Sinemet be taken – with food or not? I’m going to give the classic it depends answer J and say that consistency is a much more important factor. If taken consistently, we should be able to monitor symptoms of the disease and determine if over or under dosed. With that being said, probably the biggest change in diet/food intake that can affect Sinemet absorption is Protein intake. Per Lexi-comp Sinemet has to compete with amino acids (building blocks of protein – yes, Biochemistry matters) to get transported into the body and across the blood-brain barrier where the action on Sinemet takes place. What this means is that the higher amount of protein intake, there may be less drug able to get to the site of action. So be sure to consider this potential interaction if you note that an individual is not responding to Sinemet and eats lots of protein.

2. I know in the later stages of Parkinsons disease the meds do not seem to work. Why is this? Parkinson’s is a progressive disease, and it’s progressive because over time, the brain cells that this disease affects begin to die/malfunction. Without adequate functioning brain cells, the medication’s effectiveness will slowly decrease. This also explains in practice why total cumulative daily doses tend to increase over time in many Parkinson’s patients.