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Like most PWD's I would like to see the development of a "magic bullet" drug for PD, at least for better control, if not prevention or cure. But in the meantime, I wonder if *some* of the lessened effectiveness of existing drugs such as Sinemet are due, not to body and/or brain chemical changes, or increased tolerance levels, but to declining delivery of the active component, caused by life style and/or body function changes. I was lead into this line of thinking by two events. The first was as a result of severe dehydration and subsequent severe constipation over the holiday period (the tangled web of causes for which, I won't go into). A minor op. removed a compacted mass of pelletised faecal material, the consistency of modelling clay. To the surprise of all, an almost complete tablet of Sinemet CR was found embedded in one of the pellets! This had obviously passed right through the digestive system, and in the normal course of events would have been expelled, having contributed *nothing* to the day's intake of L-dopa! This lead me to think that both constipation and diarrhoea, constant problems for the elderly and PWD's, could lead to a reduced uptake of L-dopa, and an incorrect evaluation could lead to prescribing higher doses of medication, which then would be *too much* when the digestive problem abated. The second event involved an incident at a nursing home for elderly and incapacitated folk. A relative noticed an accelerated decline in the general condition of one resident, and increased PD symptoms. To cut a long story short, the cause was determined as too-regimented meal times, which worked against the proper absorption needs of the PWPD. I urge anyone considering increased dosages to examine the problem holistically. The cause, and cure, may be found elsewhere than in the medication. Jim