Hi: I have a general question that I hope folks can shed some light on. My understanding is that after about five years of Sinemet therapy, many PDers begin showing serious side effects. You read about them all of the time here. My question is whether these reactions are due to some accumulated toxins in (i.e., damage from) the Sinemet. Or, are these side effects simply due to the fact that after five years the degradation due to PD itself make the Sinemet more volatile? Let me pose this question in different ways: 1. If I start taking sinemet 7 years after diagnosis, can I expect the side effects to show up immediately or will it take another five years? Or will it take two years? 2. If PDer A takes half the dose of PDer B, will PDer A take longer to show the side effects? If one train leaving Chicago at 60 miles per hour and another leaving Baltimore ................. 3. I (as well as a lot of other recent diagnosees ) am making every attempt to delay starting Sinemet as long as possible. Am I deluding myself? Have there been any formal studies on this issue? Ron Reiner ([log in to unmask]) 48 + 7mos PD