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To All, I am posting a question on behalf of my mom-in-law, Suriaya Lutchmedial. She was taking Sinemet 25/100 4 x day for the 11 years. Last year her doctor uped her to 5 and started her on 1/2mg Permax 4 x day. She has never adjusted to the new meds-her bad times outway her good (despite timing and dosage strength) and reacts even worse when going back to 4. Her doctor told her that 5 Sinemet is the max and if it doesn't work look into a Pallidotomy. Has anyone heard this as well? From what we've have read, it seems like it is almost impossible to have meds work 100%. Her on/off periods are irregular and don't necessarily correspond with meds. Any hints? She read about CR at bedtime and she has been sleeping up to 4 hrs at night (twice what she used to). Confused. Thanks, Deanna Bartuccio