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I hope it doesn't seem as though I'm asking the same questions over again. My mother (67 years, diagnosed less than 2 weeks ago) is on Sinemet 25/100 3X/day. Her symptoms are: off balance inability to use left hand slowness slow speech some drooling When I ask her if the Sinemet is helping she says that it helps a little bit with the balance. Her speak sounds the same to me (this is over the phone) -- no difference. She still cannot use the hand and it takes a long time to do things. What I'm wondering is this: Should she expect more from the medication?? I know I already asked this (and received a few insightful responses), but I guess I'm wondering if the failure of this dosage to produce a more dramatic difference indicates (i) that the dosage could/should be higher (ii) that she should be on another (or should add another) type of drug, or (iii) that Sinemet is not the best drug for her symptoms. This leads me to my next question. What is the basis for prescribing one drug type over another? Does it have to do with the severity of the disease? The type of symptoms? The doctor's preference? Finally (at least for now), has anyone heard of Dr. Stuart Isaacson or Dr. Yahr at Mt. Sinair in New York. A good friend of my mother recommeded Isaacson and I was just wondering if anyone out here has gone to him. Thanks for all your help. I'm trying to prepare us as much as possible for a consultation within the next few weeks. Debbie White [log in to unmask]