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Just wanted to provide a progress report on my wife Nancy. As you know we made our trip to Washington despite battling depression, anxiety and insomnia. On Friday May 17, a week after returning from Washington, Nancy decided, with my support, that it was time to take some drastic steps to reverse her downward spiral. She admitted herself to the hospital where she was immediately taken off of Serzone and put on Effexor as her antidepressant. She also went on an enforced schedule of one to one and 1/2 sinemet 10/100 every two hours while awake. Four .5mg of permax every four hours and four .5 mg of Ativan every four hours. I believe one or two Trazadone before bedtime were also added. Sadly we celebrated her first anniversary of her first Pallidotomy in the hospital. What a bummer. On the bright side, finally, we have turned the corner. Nancy is no longer having crying episodes, and anxiety is greatly reduced. Mental confusion and short term memory have improved dramatically and she has had several nights with six sustained hours of sleep. It looks like Nancy will be released on Thursday. My best buddy is ready to come home and she can't wait to get out to play some golf and enjoy those grandkids again. This was a very tough experience for both of us, our extended family, and the many doctors involved. While we may never know for sure what took us on this downhill three month slide. The obvious candidates are: 1. Switching antidepressants from Prozac to Serzone. Something we initiated because of the expected reduced side effects. 2. The sleep deprivation mode that we were in and were trying to correct with the change in antidepressants should not be underestimated. We are being told that that the sleep deprivation alone could have caused the downward spiral. I.e. Too tired to fight back. 3. The mental confusion that reached its peak on May 17 may have been largely the result of sleep deprivation. 4. The increase in PD stiffness and loss of the ability to get out of bed which had been gained after the pallidotomy was also temporary ( thank God). Nancy is much more mobile now and moving about like she did after the surgery. She is still having some fairly severe off times but is managing through these by sticking to the sinemet 10/100 schedule. 5. There have been so many lifestyle changes mostly for the better, but maybe too many for us to absorb in one Globus Pallidus burst. Lesson learned, don't take any of these drugs for granted. What works for some may not work for others. I expect the road to be bumpy for a while now but climbing the hill, CAPITAL HILL is something we will both be looking forward to again. For the Pallidotomy gang, through out this nasty experience there never was any evidence of dyskinesia, and tremor remained mild. Rigidity did get much worse. Many thanks for all the input many of you provided regarding medications and down to earth support. [log in to unmask]