Restlessness in the afternoon

Hello @meenakshi and welcome to the Parkinson's support group on Mayo Connect. Restlessness and Parkinson's are a difficult combination for sure. As you said you have been taking 200 mg four times a day, I'm thinking that you are taking Carbidopa/Levodopa. Is that correct? There can be a problem called, Dyskinesia, that sometimes occurs after taking this medication over a prolonged period of time. Here is some information about dyskinesia from the David Phinney website, https://davisphinneyfoundation.org/what-is-parkinsons-disease-dyskinesia/

I would encourage you to read this information and then talk to your doctor to see if he or she feels that this could be the reason for your restlessness.

As you probably know, medication and exercise are both important for Parkinson's. Exercise, combined with medication, helps with many of the symptoms and delaying disability. Physical therapy can be a good way to start and then it is important to follow through with a daily plan. What type of exercise program are you using now?

YouTube has a lot of free exercise videos, that are not overly strenuous, but are very helpful to seniors. Here is a link to some of these videos,
https://www.youtube.com/results?search_query=parkinsons+exercises.
As you can see, a lot of these exercises can be done while seated.

Is your doctor a movement disorder specialist? If not, a referral to this type of specialist may be helpful for you. Movement disorder specialists are neurologists who have special training in disorders like Parkinson's and they may have ideas to help you with the sense of restlessness.

Outside of the restless feeling, what other PD symptoms are the most bothersome now? Is your gait and balance a problem?

Hi @hopeful33250 Thank you for your prompt response. I am taking at this time eight tablets of Syndopa Plus which is 100mg Levadopa plus 20 mg Cardidopa . Based on available info, would switching to Syndopa 110 with less Cardidopa help?
As for your query, I have no major issues with gait or balance till now. I do freeze occasionally while walking.

You know, the questions about dosage, would need to be made by your doctor. Next week, you could call and ask that question.

Did you have an opportunity to read the information on dyskinesia? You did not mention your exercise plan. Do you have an exercise plan that is enjoyable for you? I live in the Midwest where the weather is not always conducive to walking, so I use a lot of exercise videos on YouTube,

Proper self discipline of Exercise and diet foods will increase dopamine. Use Google to learn of too little or too much dopamine. How to increase dopamine. Perhaps too much Carbidopa????

I understand that the purpose of Carbidopa is to increase dopamine. Correct?

So I go for long walks (even with umbrellas in Oregon rain), I use an inside bike, I do stretching on the floor exercises. I ahear to home made foods: no constipation. Or used prune juice or prunes to maintain as needed. Mid day, I I often forget to take Carbidopa ...mostly because I seem to not need it. Correct?

In the evening I use CALM YouTube music instead of BUSY. Background: Soft, relaxing piano, guitar. Instead of invasive TV or Busy music, I use soft background music. Meanwhile, I work on a hobby that provides more calm.

Restlessness may be triggered by SITTING, watching TV or sceens "news" or programs or movies where people are hurting people.

Hi @ronwolf Thank you for your inputs. Will take whatever applies to me while going ahead

Hi @hopeful33250 , I am aware that certain queries could be answered only by the Doctor in charge. My point was specifically with respect to the role of Cardidopa in contributing to/ controlling dyskinesia. I thought there may be some useful info on this in the public domain.
Incidentally, your input on dyskinesia was very useful, thanks for it. I have a good exercise plan overseen by a Physio Therapist , the sessions lasting an hour thrice a week. I do walk as much as I can , lasting 40-50 mins a day.

Hi again @meenakshi

I am glad that the information on dyskinesia was helpful to you. Unfortunately, medication changes are very individual. Your doctor would need to determine if dyskinesia is the reason for your restlessness and then determine on the best course of action. You will probably not find anything in the public domain to help answer this question which is so dependent on many factors.

I am glad that you have such a good exercise program that is directed by a physical therapist. You are obviously doing some good things to help yourself.

I hope to hear from you again. Will you continue to post as you find answers?

Hi @hopeful33250 Thanks. Pl be assured I will continue to post as I receive answers.