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Fred Zwartjes and List, My neuro put me on Permax with careful instructions to "titrate". I had to increase the dosage even more gradually than the chart suggested. Although side effects usually vary with the individual, most will probably get low blood pressure (mine was quite low like 70/50) and will have dizzy spells when standing-especially at night after being down for a few hours. My wife had to help me get to the bathroom and I fell once. Your Dr. probably told you it was a dopamine agonist. It is like Parlodel which many on the list have talked about, but newer and assists the dopamine, sometime allowing a lower dosage of Sinemet. In my case the Permax has stopped my involunatry jerking of my legs, especially at night when they would keep me awake and cause me to get up an walk. He probably put me on Permax rather than Parlodel because it is more effective re invountary movements. So far I have not reduced my sinemet, but I only take 3x.25 Permax daily.