Hi - I read with interest all the comments made so far, and I hope you will find the following of benefit. I was diagnosed with young onset Parkinson's 5 years ago, and having first been put on DA's for about 18 months my consultant took me off after I bit the bullet and admitted to my PD nurse that I was experiencing significant compulsive behaviour. I was put on to Madopar (Co-carildopa) by my consultant, the compulsive behaviour disappeared, and for the first time in many years I felt really really well - so well that I even took up the sport of Tae KwonDo, and within a couple of months I took my first grading, which I passed with flying colours. My coach was really keen for me to take my second assessment in December 2012, but I had started to feel unwell so I had to reluctantly pull out. Over the Christmas and New Year I was really very ill, where I was experiencing what could only be described as significant dose failure. I contacted my PD nurse first thing in the New Year and got an emergency appointment, at which he put me on to Stalevo. [Incidentally, I noticed that not one of you had mentioned Stalevo in the above posts, and feel I need to "correct" the post by PJD (sorry PJD - I just want to put the record straight......). If you follow this link you will see there are quite a few more levodopa drugs than Madopar and Sinemet licensed in the UK to treat Parkinson's, some of them generic, some of them branded]
That was nearly two years ago..... and I have learnt a great deal about Stalevo in that time. The comment made above about protein having a negative effect on levodopa is absolutely correct. Basically, protein will take the levodopa and absorb it - effectively making it "disappear" - ta da! And there you are, unable to move and feeling like s***! But what is even more important is that Sinemet and Stalevo ought to be taken on an empty stomach - therefore to achieve maximum success you should not eat anything at all for two hours beforehand, and also for between 30 and 45 minutes afterwards. I know if I even sneak a snack eg a carrot stick whilst preparing supper an hour before my meds are due or within half an hour after taking it, can have disastrous consequences and I get limited levodopa benefit or even total failure. If I stick to these rules, I can then eat protein, but basically I need to be sensible and don't max out on the full English breakfast etc! A well-known young onset who has had PD for a great many years advised me to introduce protein to levodopa slowly - therefore a teaspoon of yoghurt on my cereal at breakfast time and to gradually increase this over time, effectively weaning myself on to the protein. Not everybody is the same, and whilst some can take stalevo within 2 hours of their last meal, and max out the protein, others may experience the opposite. It is really important though to not cut protein out of your diet as you are doing yourself more harm than good if you did, and its better to load the protein on to the end of the day rather than the start. One of my favourite lunches used to be baked beans on toast with lashings of grated cheddar on top, but that has had to be knocked on the head, together with the Brie (a particular favourite of mine). If I eat either, I can quite literally feel the levodopa dropping through my boots, hard on the heels of which I experience a massive dystonia attack - which I wouldn't wish on anybody as these are incredibly painful.
Having spoken to my GP and pharmacist about what went wrong Christmas 2012, we think I was either dispensed "the wrong" Madopar by mistake, or perhaps even a counterfeit drug, which according to my GP is a massive problem with regards to neuro meds as they are so expensive, and hence an obvious target for criminals. As I was definitely more stable on Madopar than I've ever been on Stalevo I've recently spoken to my PD nurse about a trial period back on madopar. However he has warned me that my problems with Stalevo are more likely to be attributable to disease progression than the drug itself, and whilst he's happy that I try Madopar again, he's also written to my consultant with the recommendation I go on to Apo-Go sooner rather than later if Madopar doesn't work.
So, to recap, timing of food and a healthy balanced diet including tolerable amounts of protein are really key to successful levodopa uptake. Oh yes, and loads of rest and exercise.
Hope this helps clarify things for you. xx