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My father-in-law had a recent experience which is worth sharing. Recently sinemet came off patent, paving the way for generic "sinemet", which his pharmacy started providing him instead of the branded medication. At about the same time he stopped taking amitryptaline (an anti-depressant) which had been prescribed to help him sleep. For the past month or two, the entire family noticed that he seemed to not be doing very well, with increased PD symptoms, more shuffling, less participation in what was going on, etc. Several times his knees gave out and he collapesed, which had never happened before. When my mother-in-law noticed the switch to generic sinemet, she had the pharmacy refill the prescription with branded sinemet, and got my father-in-law to restart the amitryptaline. The change was more than dramatic! Decreased shuffling and tremor, regained full participation in the conversations around him, easier eating; he seemed years younger than he had around Christmas. We're not sure how much of the change was the result of the generic vs. branded sinemet, and how much was the absence and reintroduction of amitryptaline. Before sinemet came off patent, physicians didn't need to mark prescriptions to Dispense As Written (there were no alternative medications); now others may want to pay attention to whether there are differences in efficacy of the generic vs. branded. --- Dave Rosenbaum