Treatment · 20–21 October 2026
20–21 October 2026: A Medication Change and the First Night
During a family-reported return visit to Dr. Shivam Om Mittal at Cleveland Clinic Abu Dhabi, Madopar HBS was replaced with scheduled Madopar Dispersible 125. Early mobility seemed better, but the first night brought sleeplessness, unclear speech and chewing-like movements.
By an anonymous caregiver · 2 min read
Personal experience, not medical advice. This is one family's account. Never start, stop or change any medicine without your doctor. New or worsening slurred speech, facial drooping or sudden weakness can be an emergency — seek urgent medical help immediately. Full disclaimer
On 20 October 2026, my father's regimen changed during a return visit to Dr. Shivam Om Mittal at Cleveland Clinic Abu Dhabi — the neurologist who first saw him in 2024. This visit and the change are family-reported. Madopar HBS 125 was replaced with Madopar Dispersible 125, one tablet every four hours, five times daily, alongside Oridopa 25/100 two tablets five times daily. The new regimen started at around 4 PM on 20 October. The exact clock time of the fifth daily dose is not yet verified.
The numbers
Counting scheduled doses only, levodopa went from about 1,300 mg/day to about 1,500 mg/day. Each Oridopa 25/100 and each Madopar 125 tablet contains 100 mg of levodopa; the remaining amount on the Madopar label is benserazide.
What the family observed
In the early hours, our family reported some improvement in mobility. But we also saw things that worried us:
- Prolonged sleeplessness overnight.
- A morning OFF period on 21 October when he needed assistance.
- Intermittent chewing-like movements.
- Recurrent unclear speech, which seemed worse overnight.
These could possibly relate to dyskinesia, but nothing has been diagnosed. I am recording them as observations only and reporting them to his doctor.
A careful note on timing
We noted that he seemed ON from around noon on 20 October until around 4 AM on 21 October. That window began four hours before the medication change. It would be wrong to attribute that whole period to the new medicine, and I will not do so.
Blood pressure on the same night
On 20–21 October a blood pressure reading of around 90 systolic was reported, rising to around 125 about 30 minutes later. We do not have the diastolic values or his position at the time. I record this as part of his clinical history, not as a Parkinson's medication effect.
A safety reminder
Any new or worsening slurred speech or facial drooping can be a medical emergency. Families should seek urgent medical help immediately rather than waiting to see whether it is a medication effect. We are discussing every one of these observations with his neurologist.