>To All and Deanna Bartuccio in particular: There is an important piece of information missing from Deanna's message: why did her doctor increase her Sinemet to 5 per day. Ther must have been one. Otherwise, her increased suffering since this event would not be tolerated. Did she start immeiately with 0.5 mg Permax (pergolide) 4 times daily , 2 mg total. That is alot. I can't tolerate more than 0.75 mg (But it helps my PD). Has your mother had a consultation with a neurologist who sees alot of patients with PD. I feel, unease with the way dosages were adjusted and the introduction of possible pallidotomy to make up for the therapeutic failures. Please do that. I am not qualified to treat patients with PD. Good luck; keep us posted Steven E. Mayer [log in to unmask] > >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 > > Steven E. Mayer, Ph.D.