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Subject: Testing Hello everyone, There have been a number of interesting inputs to this subject. I would like to comment on one aspect where (thanks to the march of progress) the situation has changed. It was true not very long ago that the only definitive diagnosis of PD was by autopsy. However the improvements in resolution achieved by the latest scanners have made it possible actually to see the dopamine functioning in the brain. A sufferer of PD shows up immediately with a much reduced spread and reduced activity. It is by testing of this sort that Neurologists at the University of Nottingham have been able to show that a person who does not have PD generally shows no loss of dopamine capacity throughout their lifetime. However scanners of this power and resolution are far too busy on fundamental research to be used for routine examination of people who may or may not have PD, so in practical terms are not much further forward. I agree with the comments of Dick Swindler, that witholding levodopa tablets for 24 hours, or however long it takes to decide whether it was having an effect, will have no long-term effects (good or bad) on the patient's response to levodopa. I am not a fan of the Drugs Holiday concept, - I suspect that the claimed benefit when the drugs are resumed is mostly sheer relief at the release from torment.) The next point may be drifting off the subject a little, but I think it is worth raising: Many people (Not only PWPs) ,after several years of treatment, find themselves swallowing an increasing number of different tablets, each tablet having been provided for what seemed to be a good reason at the time, but many of them in fact merely cancelling another drug prescribed at some point in the past. Eventually someone (Usually a Consultant because the lower ranks don't have the nerve) enhances his reputation even more by stopping all the tablets in one grand gesture - and the patient feel better!! It can happen with PWPs as well. I know of cases where a high dose of my favourite 'bete noir' (Bromocryptine) ,prescribed in a misguided attempt to avoid levodopa, resulted in hallucinations and other psychiatric disturbances. To counter these symptoms some powerful drug such as Clozaril was prescribed, necessitating weekly checks because of the possible side- effects, etc ,etc - And all for want of a bit of levodopa. An example from outside the PD world was recently brought to my attention, when my mother (Who at 87 years old has pretty bad circulation problems particularly in her legs), had a whole battery of drugs swept aside, and replaced by a simpler, less aggressive (by which I mean carrying a much reduced risk of side-effects) routine, and feels better for it. Does your list of 'active ingredients' make sense if you stand back and look critcally at it ? Regards, -- Brian Collins <[log in to unmask]>