First visit (visit 1): Start on level 1 dosing with 4 Neuro-R in the AM (upon rising and 4 PM (5 to 6 hours before bedtime).

  One week after first visit (visit 2): See the patient back in clinic one week after initiation of treatment. At this point there needs to be an evaluation of desired results. It takes 3 to 5 days after starting Neuro-R at the initial visit for maximum results to be seen. The correct question to ask the patient is not, "How were things last week", but should be "How were things yesterday?" Since it may take 5 days for maximum results to be seen asking about the results yesterday is more appropriate. If the desired results are seen after one week continue Neuro-R at 4 pills twice a day then schedule a follow up appointment in one month. If the desired results are not seen after one week increase the patient's dosing to level 2 of "Table 1" above then see the patient in clinic one week later.

  Two weeks after the first visit (visit 3): For patients increased to level 2 dosing at the second visit see them back in clinic in one week. Again, ask the patient, "How were the results yesterday?" For those that have the desired response continue on level 2 dosing then schedule a follow up appointment in one month. If the desired results are not seen after one week increase the patient's dosing to level 3 of "Table 1" above then see the patient in clinic one week later.

  Three weeks after the first visit (visit 4): For patients increased to level 3 dosing at the third visit schedule a follow up appointment in one week. Again, ask the patient, "How were the results yesterday?" For those that have the desired response continue on level 3 dosing then schedule a follow up appointment in one month. If the desired results are not seen after one week continue level 3 dosing then obtain a urinary neurotransmitter test from CHK labs to evaluate the status of the organic cation transporters of the proximal convoluted renal tubule cells of the kidney leading to ability to balance monoamine neurotransmitters further.

  Urinary neurotransmitter testing: The urinary neurotransmitter testing of DBS labs directed by Tom Uncini, MD hospital based dual board certified laboratory pathologist is not performed to determine the urinary levels of neurotransmitters. If is performed to ascertain the functional status of the organic cation transporters (OCT) of the proximal convoluted renal tubule cells. The OCT of the kidneys are "identical and homologous" with the OCT of the liver, GI tract, and brain. Optimization of OCT function is critical to balancing monoamine neurotransmitter function when amino acid precursor do not obtain the desired results in treatment. An in-depth discussion of the scientific basis for urinary neurotransmitter evaluation of OCT function is discussed on the "neurotransmitter testing" hyper link in the upper right column of this web page.