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I thought I'd throw in 3 or 4 cents to this discussion, especially with my new extra-sensitive outlook toward sinemet. Recent experience has led me to an ultra-conservative approach to mainstream anti-parkinsonian meds. We all know sinemet is no cure, I know that it allows me to do things that I wouldn't be able to do without it, such as work, walk the mall, etc. It is a two-edged sword though, because it also masks an underlying fatigue that is numbing my mind and memory, and what else? I think the bone-crushing fatigue, which is the state of my REAL health would dictate that I get a lot more rest than I do, but the sinemet gives me artificial energy plus keeps me awake at night, so I end up on a treadmill leading to a chronic state of fatigue. Not conducive to health. Also, there's that charming prospect of hallucinations and delusions that we are all risking when we use sinemet. After the last three weeks with Ron, I will do ANYTHING to avoid that fate, including stop using sinemet. Thank God the Mirapex is filling in for me, and I am day by day eliminating sinemet from my drug list, fervently hoping that I will be able to eliminate it totally. So far, since Janet's post and some others advice I have cut back by half, and am feeling MUCH better. I don't see how we can criticize anyone for saying NO to sinemet, considering the long term potential risks. Especially a 45 year old man with 40 years of PD to look forward to. How would you like to be on sinemet for 40 years? Not me, I am in his same boat, and it scares me to death. The only way I can rationalize the use of any sinemet is by convincing myself that soon something (like a cure) will come along and rescue me from the outcome of my choice to use it. And Charlie, I understand your point about refusing proven treatment being foolish, but I have a friend who now has tardive diskynesia from years of anti-psychotics. She didn't have a choice because her ability to function is so low, but she is paying a high price for following the established treatment mode. A question with no easy answers... Kathie Tollifson [log in to unmask] 47/9