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Hello George, You asked to hear from someone with a similar situation and for thoughts to discuss with your Neuro. I can sympathize with your dilemma. I am not an MD but I have been my wife's caregiver for over 20 years. Having said that, here is a summary of our experience. First thing that matters is the known fact that as time progresses the medication has less and less effect. We ended up with a 3/4 hour schedule starting at 6 am [5 doses daily]. You don't mention how long you have been on these meds but I would assume that you have used them for many years. No two people react the same but you might ask about using Permax to give Sinemet an extra boost. We found CR to be very erratic as to response and longevity. We also found generic Levadopa to be of little value. My wife did not respond to it and we went back to regular Sinemet. We found that Comtan will extend the "on" time also. She was on Permax, Sinemet and Comtan 5x daily for quite a few years and it worked great up until this past year. At that time the medications slowly became erratic and unpredictable. That was when we decided to have a DBS operation. She now has no tremor and her speech and walking problems have greatly improved. I hope that we have helped you in some way. Ron ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn