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Freda - You wrote "My mother has been diagnosed --------" You and your father have all of my sympathies, I am caregiver for my wife Helen (81/6 years) . We had an appointment with her neurologist yesterday, and came out if not happy, at least reconciled to her present position Helen's main symptom is progressive tremor, which started in her left hand, and has, progressed through to both hands and mouth. Her initial treatment was disipal,(orphenadrine hydrochloride). For a fortnight it was wonderful - stopped the tremor in its tracks - and we both thought that if this was Parkinson's we could live with it. However, the tremor came back, and the side effects of nausea and general illness became unbearable. Back to other medication, and at various times she has been on:- a) propranolol (a beta blocker - used we understand by snooker players to reduce their tremor). No effect on Helen's tremor. b) eldepryl (selegiline), this initially was taken more at our insistence for its claimed neuroprotection properties, and she stopped as a result of the BMJ article on its,association with a high mortality rate. Although I should comment that her tremor has progressed significantly since she stopped taking it. c) Madopar CR - this had no discernible effect on the tremor. d) Procyclidine hydrochloride this gives some allieviation of the tremor. e) Pergolide (permax) patterns of light on the periphery of her vision - start of hallucinations?. No effect om tremor. f) Disipal with domperidome - no effect on tremor. g) Requip (Ropinorole) - initially at 3 X 0.25 mg/day. On the first day the tremor was significantly reduced, but returned for the rest of the week; when she went on to the next stage of 3 X 0.5mg/day there was no effect until the evening on the first day, when her whole body started to shake very violently. The second and third day saw the tremor back and, if anything, with more force, and she cut back to 3 X .25mg/day and then stopped until she saw the neurologist. This brings me back to the point of this posting. In effect the neurologist's comment was that she had been there, taken that, and he had no other medications to offer. She had tried the conventional and approved treatments of levodopa and anticholinergic drugs and if these did little or nothing for her symptoms she was better off not taking them because of the undesirable side effects she suffered. Only she could decide if she was getting any benefit, and as none of the drugs cured Parkinsons, and there was doubt about the neuroprotective properties of eldepryl, and concern about its association with heart failure, it probably wasn't worth while taking this. This left a rather bleak picture, as we go to the medics in the confidence that they have a cure for everything, but his comments to a simple engineer like my self, started a train of thought. With many diseases, such as pneumonia, high blood pressure, schizophrenia, cancer and so on, there is either a cure or something to slow down the progression of the disease, and it is well worthwhile putting up with the unpleasantness and side effects of the treatment to gain the benefits. However, if at present, there is no cure for Parkinsons, and no treatment to prevent its progess, and the available medication only treats the symptoms, it opens up a whole new ball game. Only the patient can tell if there is benefit being obtained from the medication, and this should be adjusted by the patient to suit his/her particular symptoms. As most of these drugs are very potent, and can have serious side effects, any changes, particularly for increased doses, or for new medication will require medical monitoring, as they should be aware of serious adverse consequences. In any case it must be sensible to make these gradually so that the body can aclimatise to a new regime. But only the patient, or his/her caregiver, can say if the discomfort from the treatment is worth the benefits, and it would seem that discontinuing Parkinson medication will have no effect on the long term outcome. . When I read of the variation in dose rates which are given on this List, and of some of the problems of hallucination etc., which are described I am left with the query as to how much of the problem is due to the disease, and how much is caused by the medication. If the latter, is the reduction in Parkinson symptoms worth the associated discomfort of the treatment, and can this be reduced by the patient optimising the doseage to suit him/her self?. All the usual disclaimers apply - I can't afford any expensive legal action - but I would welcome comments from any one who is more knowledgable; after all it is Helen who has Parkinsons, not me!. Ray Lakin ([log in to unmask])