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Dear Jon, I had a really horrible reaction to Permax when it was first prescribed - I took 1/2 of a .05mg tablet before I went to bed, as instructed, and was violently nauseous and dizzy from early the next morning through the whole day. I was really ready to call it quits, but my neurologist persuaded me to wait a day or two, then give it one more try. I did, and continued ramping up with it VERY slowly (1/2 of a .05 more every three or four days, until, now, I take two .25mg tabs with each meal and 3 .25mg tabs when I wake up around midnight or 1am. Adding them to my meds has enabled me to cut back greatly on the Sinemet - I take 1/2 of a 50/200 CR three or four times a day, instead of the five whole ones I was taking pre-Permax. This has pretty much eliminated the really bad dyskinesias I was experiencing with so much Sinemet. I know there are people who can't tolerate the Permax, but by increasing the dosage very, very slowly, perhaps it could work better for you. Good luck!! Norma .