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Roberta, Initial symptom--tremor. Md prescribed Elavil (Amytriptolene) and it helped immediately. Now take L Dopa (Elavil) been taking it for 6 years. When I don't take it, I feel no only the tremor, but uneasy and restless all over--inside and outside. The "Let Down" is not to be feared but to see as a signal that it was working and now you need some more. If one experiments with timing, there's no reason "Offf" periods can't be minimized or even completely eliminated. Hope this helps. Richard Naples, FL 62(12)