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Hi! my name is Jeanne Deuschle. I am writing for my husband,Kurt(73yrs) who has had Parkinson's for 12 yrs. Kurt's Parkinson's is rather atypical ...although he has tremor, motor problems etc. they do not present as much of a challenge as his autonomic nervous system dysfunction which is manifest by (1) orthostatic hypotension that requires daily florinef,salt tablets,and rest after meals and (2)a neurogenic bladder that causes many problems. Kurt is on sinemet (a total of 650mg. of levodopa daily),and is no longer on deprenyl. In the past two years Kurt developed cognitive problems that became increasingly severe (hallucinations and delusions) and made it necessary for him to take a neuroleptic drug (closapine). After much testing etc. it was concluded that his problems were for the most part drug related ...ie. sinemet and deprenyl. The deprenyl was stopped, but the sinemet could not be. While the clozaril (56.25 mg.@ 9pm nitely) has handled most of his cognitive problem,...it is at a high quality of life price! Kurt is "groggy" and weak much of the morning and his blood pressure is also slower to stay "up". We have tried to lower the dosage of clozaril, but found that the current dosage is probably optimal. Kurt has been on the drug for 1 year now. Has anyone had experience with the problems I have described? Autonomic (blood pressure/bladder problems....clozaril problems? ) Any suggestions? Also, although we understand that pallidotomy is probably not an appropriate procedure for Kurt, and indeed he would most likely not be considered because of his cognitive problems.... Has anyone with his autonomicand/or cognitive problems had a pallidotomy? What was the result? Does anyone know of any studies or special work being done in the area of drug related dementia in Parkinson's or autonomic system problems in Parkinson's? In spite of all of these problems we are ever hopeful...