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Hi Bob and Philip, Your comments an large doses of sinemet were very interesting to me. I am taking 900 mg of levodopa in sinemet but I also need 5mg Permax (pergolide), And I had a pallidotomy last april. Visiting the doctor- Most of us try to be "on" for neurologist visits I was very good at this and my doctor made the same type of comment "wouldn't know you had parkinsons" Then a friend commented that her neurologist had a better attitude after he saw her in her "off" state. So I arranged to do some "end of dose wearing off" during my next visit. I walked into clinic, and by the time I was ready to leave needed to ride in a wheelchair. Needless to say my doctor was surprised, always seeing me in what I call my functional state had not prepared him for the awfulness of the not-functioning state. Variations in Response to Sinemet- I think you are right in feeling that there are great differences in the efficiency of processing and getting good value out of our antiparkinson meds, particlarly sinemet. You take a lot but if it works for you--don't change for the sake of change. "If it ain't broke don't fix it" is very true. However I learned an interesting fact about sinemet last year, when adjusting my dosage guided by my neuro and Alan Bonander. There is quite a difference in the bioavailablity of levodopa in CR sinemet as compared to the regular. sinemet. Approximately 90-95% of the levodopa in regular sinemet is bioavailable but only 70-75% of the levodopa in CR is bioavailable. I found that changing some CR to regular gave me a better day possibly due to more of the good stuff getting into the brain. Comments anyone? Anne Rutherford <[log in to unmask]> Newfoundland