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Re: RLS/Sinemet rebound

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Dorman

Sinemet rebound refers to a change in severity and time of occurrence of

RLS symptoms linked to taking Sinemet. It can occur with Permax and

Mirapex, but is much more common with Sinemet. It is frequently

accompanied by another change called augmentation. These two terms are

frequently used interchangeably and the difference in meaning is not

really important. The important thing is that the RLS symptoms get worse

and occur earlier in the day than before you started the medication.

These changes have been shown to be related to the total dose per day of

Sinemet. If you limit your daily dose to three or preferably two of the

25/100 Sinemet tablets or 1 1/2 or preferably 1 of the 50/200 Sinemet CR

tablets, it is much less common. It usually takes weeks or months to

occur, but is the main drawback to using Sinemet. Some people say that

they got rebound and/or augmentation in a few days or a week. I don't

think that is really the case. I think that, in their case, the Sinemet

just didn't work, period. Increasing the dose of Sinemet is absolutely

the wrong thing to do. It just makes matters worse. The way to deal with

rebound/augmentation is to switch to another drug.

It is not unusual to pinpoint some event as the cause of an illness, in

your case the exposure to fertilizer. Usually, the two are not related,

they are just coincidental. I am sure that there are exceptions, but

they are not common.

Dr. Levin

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