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Dopamine antagonists are not as commonly used any longer. they block dopamine receptors in the brain. they bind but don't stimulate. in a way they copy the effects of dopamine and are still used for their anti-psychotic effects.
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I have worked with people who have parkinson's, and have a lot of experience with this lousy disease.
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Antioxidants to scavenge free radicals: coq10 is the one which is now being suggested even by the mayo clinic at 1200 mgs per day. vitamin e complex and vitamin c with bioflavonoids work synergistically. beta carotene - the vitamin a precursor is helpful but remember, the body stores vitamin a and there is no need to overdo it.
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Why wouldn't the drug sinemet be in the 2010 physician's desk reference (64th ed.)?
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Well if you're talking of a very controlled medication i don't thing they would sell it just like that, because you have to gave to the pharmacy a special prescription and they only will give you the quantity that the prescription says, you can always buy it in the black market but i think its not worth it.
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The first thing she needs to do is have a frank discussion with her doctor about prescribing the generic versions if they are available. no, they are not always identical - not many controlled releases to provide a constant serum level for example - but close enough. there don't appear to be many if any pd meds on the $4.00 prescription list but that doesn't mean that a generic won't be much less expensive. another reason to speak to her doctor is to find out if he has samples available. a final reason is to find out from her doctor's office if there are better medical plans which might be open to her.
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There are dopamine agonists which mimic dopamine - stimulate a response. they bind to different dopamine receptors. one function is to raise prolactin levels. like the dopaminergics, they have a wearing off time which increases the longer one is on the medication. often they are coupled with a dopamine antagonist. these meds include parlodel, requip xl (non-ergot derived), mirapex (can cause hallucinations and compulsive behavior but excellent for pd symptoms if you can tolerate the side effects), the neupro transdermal patch which is awaiting re-approval by the fda in the us market. it has been restored to the european market following a glitch which did not impact its effectiveness. there are more but not as commonly used or not available in the us market.
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Does the doctor see and adjustment in meal time (especially protein intake vis a vis the sinemet timing as protein can interfere with the levodopa)
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Comt inhibitors - inhibit the catechol )-menthyltransferase enzyme to inhibit the break-down of dopamine after its relese in the brain. they begin to work immediately after the 1st dose. they are often combined with levodopa-carbidopa later in treatment. common names include comtan (entacapone) tasmar (tolcapone and stalevo (which is a combination of levodopa-carbidopa-entacapone)
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Sinemet 62.5, sinemet 110, sinemet plus and sinemet 275 tablets all contain the active ingredients levodopa and carbidopa. this combination of medicines is also sometimes known as co-careldopa. it is used in parkinson’s disease to increase the levels of dopamine in the brain.
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Another thing which you can consider for the dyskinesiadystonia is iffy but i'm going to mention it anyway as some people claim it is effective (i've seen it have a slight calming effect on my husband)
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