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A little about myself - I am 64 and have had PD since 1985, I am English but live in California. The progression of my PD has been fairly slow and at my very best,few people realize that I have it. At my worst it is very much how you describe your dad. I do not have tremor or freezing. The Brady Kinesia seems to proceed rigidity - that also seems true of Dystonia. In my case it seems to start in my right toes and work its way up my body. I have sometimes described the rigidity as though I am full of wet cement that is slowly hardening, until at its worst I am absolutely immobile. My legs and arms feel as though they weigh at least 300 lbs.a piece, and my head becomes so heavy it leaves a dent in my armchair. When this happens, which is almost always in the evening, it is painful, every muscle seems to contract and I have like a vice grip around my rib cage, which my caregiver can usually manage to massage away, so enabling me to sleep. My breathing becomes fast and shallow and its easy to feel panicky, I can completely identify with your dad. To get to the point, which is whether your Dad is over medicated, I have slowly been worked up to the following levels, by my specialist at the "City of Hope" Parkinson's Center of Excellence" in Monrovia, California: Sinemet CR 50/200, 2 x daily Sinemet CR 25/100, 5 x daily One half of a Sinemet 25/100, 4 x daily as a booster to get the CR started for the first four doses of the day Permax 0.25, 6 x daily Amantadine 100, 2 x daily (currently not too effective) I take the first dose at 6am and then every 3 to 4 hours thereafter, depending on the size of the CR that I last took. I take one of the small CR's when I wake around 2am, sometimes I sleep after, sometimes not! I also take a mild anti-depressent, Pamelor, and a muscle relaxant at bedtime. If you compare the time since diagnosis for your Father, and my own diagnosis it would seem to suggest that he is over medicated, and while each persons PD can be different, some PD literature suggests, that sinemet paridoxically can increase the symptoms its supposed to relieve. ( I'm sure that many more people will answer your letter, so you should get a cross section of opinion on too much, or too little sinemet. I would suggest that you try to get your Dad an appointment with a Neurologist who specialises in PD and has a reputation as a "fine tuner" of medication. I cannot tell you if there is a Parkinson's Center of Exellence, in Holland, but as soon as this letter is published on the list, I'll bet someone out there will know, and will tell us. Your second question about whether your Dad's PD is progressive - I think it is universally believed that PD is so, but I would like to tell your Mother and Father to HANG IN THERE, because there is so much that can be done to improve, if not reverse the symptoms and I am living proof of this; a year ago I was a zombie, no energy or strength for anything, all I did was to sit and sew, no appetite and down to 93lbs weight; I could hardly string a coherent sentence. Now thanks to cutting back on meds.(no more tranquilizers) plus exercising to music three times a week,and being occupied with my hobbies all the day long, I feel a whole lot better. I've still got PD and I still have painful symptons, and I long for a few hours of just plain simple comfort, ( I still get Dyskinesia from the slightest GOOD or BAD stress) I don't get so panicky, and I know the feeling of not being able to breathe WILL pass. I know I WILL be able to move again, and I know that PD its self is not terminal. (although some complications can be) That so many people with PD are so much worse in the evening, I think is due to a combination of things: 1. A heavier than necessary evening meal 2. A lot of protein in the evening meal 3. Sitting - too much TV watching or reading without getting up to exercise and you're done for: you've got to keep movin, movin, movin, until sheer exhaustion force you to quit. ' Finally Susanne, I want to tell your Dad that the best medication that any PD'er can get, he already has,in fact he has a double helping, a caring spouse and a daughter, who by her letter to us all, asking for help for her Dad, shows her very deep caring. They don't come any better Dad! Stay in Touch