Barb, I've been part of the pramipexole study at Washington University in St. Louis for three years. For me, the principal benefits have been an improvement in balance, handwriting, and constipation. If I'm "off" when I take it, I don't go on, but if I'M on, that dose seems to become more effective, sometimes to the point of causing dyskinesias. I don't notice much effect of subsequent doses, but I might notice the difference if I weren't taking it. Hope that helps. Pat Schark P.S. My neurologist is also heading the tolcapone study, and seems to feel that's even more effective.