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Jackie I am surprised the ND did not cut back on the Mirapex. I made the mistake of giving Mel his with the Sinemet 50/200 every 8 hours. I should have given the Mirapex with his 3 daily meals. He is doing much better after having some weird side effects 3-4 hours after the doses of Sinemet and Mirapex together such as hipe-er big time and trying to leave the house and combative at 2 am. He is much better and resting well with his Mirapex .25 three X daily and Sinemet down from 50/200 every 8 hours to a substitution of 25/100 CR for the mid dose of sinemet. He does dose a lot now in the day but manages to sleep fairly well at night. The only reason the ND has not got him up to .5mg of Mirapex (the expected goal) is because of the side effects-I'm to call her back in 2 weeks. Good luck as you troubleshoot the titrating of the meds-know we have been there and suffer with you in your concern. Mary CG for Mel 76/11