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Dr. Cheryl Waters of USC Parkinson's Center published a report on leg spasms and toe curls (dystonia). Her report stated these painful spasms accure only when off medications. They seem to be during periods when the patient is starting medication or when the patient is going off medication. This implies: (1) Those experiencing these dystonias all day, are never in their therapuetic window, I.e. they are off all day. (2) The only logical times to experience dystonia is in the morning when we take first medication and in the evening when we go off for nighttime. I would guess it would be better to startup quickly so as to minimize the time off. The medication with the fastest startup time is Liquid Sinemet followed by regular sinemet. The use of sinemet cr as the first and only startup medication makes no sense It takes an hour longer for CR to peak than a 25/100 regular. And then the peak for CR is lower than for regular. I have heard many patients claim that the dystonia started about the time they started on CR. I am not saying not to use CR. Just don't use it as the only medication to start the day if you are experiencing dystonia. Regards, Alan Bonander