Initial Effect of Sinemet

Posted by Shane @enahs, Apr 10 12:21pm

I am about a year into relevant PD symptoms: left hand tremor, weakness, tiredness, etc. Just now am at the point when I am agreeable to starting Sinemet. But I find information on it confusing. Lots of problematic side effects, but no clear info on what advantages I might expect and how soon. For instance, some say it will help the tremor, others say probably not. So for those who have experienced this route, what can you report?

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cartercd | @cartercd | Apr 10 1:13pm

Currently taking Sinemet.
When I first started taking, I had severe brain fog. The doctor told me to stop taking it. I was taking half a tablet three times a day. He eventually titrated me up to a full tablet three times a day and so far I’ve not had any issues. I was diagnosed in June 2022.

Shane | @enahs | Apr 10 1:20pm

Can you report any clear advantages to the drug? Any symptoms markedly improved?

Teresa, Volunteer Mentor | @hopeful33250 | Apr 10 1:50pm

Hello @enahs and welcome to the Parkinson's support group on Mayo Connect. As you undoubtedly know, medication affects each person differently, so my experience might not be the same as your experience. With that said, my symptoms of balance, gait disturbance improved greatly with Sinemet. As you are probably aware, Sinemet, has long been considered as the gold standard in PD treatment and is often the first medication that is tried.

My neurologist titrated the medication very slowly. I started with a 1/2 tab, once a day for one week and each week increased by a 1/2 tab. By the third week, when I was taking a 1/2 tab three times a day, I was noticing a considerable increase in control over my gait, foot dragging and fatigue. Over time, I increased to three full tablets a day.

As I said, not all people will respond the same, but for me Sinemet was a miracle drug, and I was grateful for the improvement in my symptoms. There are, however, many newer drugs available to treat PD and as you work with your doctor you can find the right med as well as the right dosage. I would say that the important factor would be to titrate as slowly as possible to minimize possible side effects. If you encounter too many side effects, it can discourage you from continuing treatment.

I've never experienced tremors so I can't speak to that symptom, so perhaps your doctor can add another med to help with that. Many people with PD take Amantadine for tremors. It could be that you will need a combination of more than one medication to treat the different symptoms you are having.

In addition to medication, another important factor in reducing symptoms and prolonging possible disability with PD is exercise. Exercise combined with medication and a healthy lifestyle are tremendously helpful. One, without the other, will not be as effective. There are physical therapists who are specially trained in PD who are great. If you have not yet been referred for physical therapy, I would encourage you to ask for a referral.

Movement disorder specialists are neurologists who have specific training in disorders like PD. Are you currently seeing a movement disorder specialist or a general neurologist?