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My Mom was on Permax but since she changed doctors, he has her on Sinemet Immediate Release ONLY, taking 3 tablets every 3 1/2 hrs. The only other thing she is taking is Paxil 1 per day for depression. She is doing much better than when she was on Sinemet, Permax,Mellaril & something else that I can't recall the name of. Her new doc says she is an excellent candidate for Pallidotomy but prefers to keep that as an option for when he can't tune her up with medication. We prefer that option, too, but were ready for the surgery if he said go ahead.