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The neurologist I see said much the same things...either too much Sinemet or not enough.....either side effects of the drug or symptoms of PD. I really haven't figured out which it is yet. I cut the dose of Sinemet by 1/3 for over a week and still had the twisted foot PLUS a trembling hand. Now I'm supposed to adjust the Sinemet and Amitriptyline up and/or down until I reach a happy balance....no twisted foot...no trembling hand or as close to that as I can come on any given day.