The effects (or sometimes lack thereof) of medicines

From the beginning of this adventure, I’ve been told that the medicine I’ve been taking would gradually lose effectiveness as time goes on. Of course, I think that’s true for just about any condition if you take the meds long enough. I have a pretty strong cocktail these days.

As you will find out in a future post, when I received my official diagnosis in 2014 at the age of 37, I was told that it would be best to stay away from medicine as long as possible. And I think I made it pretty close to 3 1/2 – 4 years before I started.

The main drug is Carbidopa/Levodopa 25/100 – its regular name is Sinemet. This is the generic. Now I can’t remember which does what exactly, but the 25 mg of Carbidopa, I feel certain, is what prevents the 100 mg of Levodopa from going to places in the body where it should not go. I could have that reversed, but it is the main thing that helps calm the tremors and helps me to be able to do things – including typing this post!

Originally I was put on Selegiline. I had to take one when I got up and one NO LATER THAN 1:00 p.m. as it would supposedly keep me up at night. (I often remembered to take the second one at 5 p.m. and had no problem sleeping.)It’s an MAO inhibitor which helps to slow the breakdown of the neurotransmitters – one of which is dopamine! It never felt like it did anything. I would still shake, but that was back in the day when the tremors still seemed pretty mild.

About six months later, in August of 2018, I was given the C/L 25/100 I mentioned above. I had to gradually start it over the course of six weeks or so. I remember it took from the tail-end of August to mid October. Seems to me I took 1/2 tablet in the morning and 1/2 in the evening, and introduced a half a tablet each week until I was taking 3 whole tablets a day.

Since then we’ve added a few more “half tablets” throughout the day and a night-time dose of C/L 50/200 controlled release. My PCP also added a blood pressure tablet. High BP runs in one side of the family and if you can believe this, it has not only calmed me considerably, but I have gone from “loose fit” to “regular fit” pants. That’s a win!

I remember taking that first half tablet in 2018 though. I remember the instant feeling of feeling “normal” for the first time in a few years – almost instantly! And I stopped taking the selegiline because I felt this was doing the trick… and it did… for a while.

But the 50/200 controlled release is a different story. Obviously a little more potent, the idea is for it to get me through the night and when I first get up so I am not shaking too much before the first daytime dose at 8:00.

For the last 6-9 months, the dosing has gone like this:

  • 8:00 a.m. – 1.5 tablets of the C/L – 25/100; 5mg Selegiline
  • 11:30 a.m. – Repeat 8:00 a.m.
  • 3:00 p.m. – 1.5 tablets C/L – 25/100
  • 6:30 p.m. – 1.5 tablets C/L -25/100
  • 10:00 pm. – 1 tablet C/L 50/200 CR; and the BP med

I have managed to get by with one nighttime tablet for about 18 months. But lately I’ve noticed that getting up in the morning was a bit challenging. Lately the 3:00 p.m. dose hasn’t been doing much good either.

Dr. B. gave me her blessing to up the 50/200 to 1 1/2 tablets for a week, and barring any negative effects, increasing it to 2.

Now let me tell you – elevating that dose by half a pill was no problem. But when I raised it a week later to 2 – HOLY SHIT! The dreams! The dreams are terrible! I have had repetitive dreams – though very few at a nightmarish level – some based on elements of events from the day before. These just go around in circles and I seem to be unable to get out of the situation… until I wake up… almost always at 3:30 a.m. and can be awake anywhere from 15 minutes to 2 hours.

Getting to Dr. B. by email took a few days, but she responded that if I was getting to 8:00 a.m. with fewer tremors to keep it up and only to revert back to 1.5 if I really had to and it would eventually work out. I must admit that I reverted back that night and the dream was so horrific I was glad Baby Red was spending the night with me! 2 tablets it is!

The 3:00 p.m. dose has been upped to two whole tablets too. After I experienced what had to be the WORST tremor situation on an afternoon where I was expected at an event. Fortunately I was on site, but locked in my bunker shaking my sillies (and a lot of other things) out. Just a half tablet more improved the situation immensely.

I am grateful for medicine… but I truly hate the adjustment period!

1 comments

    • Mary Papik on June 20, 2021 at 2:00 am

    Eric, I do hope you compile all of these and create a book that can guide and inspire people with all kinds of medical and mental issues. I find myself reading them and kicking myself for not trying harder or whining over small stuff. Your positive attitude is remarkable.

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