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Joan - You didn't say whether the doctor recommended an immediate decrease in Sinemet. I just want to reiterate that it seems that the key to success with Mirapex is to reduce the Sinemet right away. Remember that the study showed that the trial subjects reduced their Sinemet by 27%. To add Mirapex to a full dose of Sinemet, if the patient is more or less adequately medicated on Sinemet in the first place, is almost certain to cause severe dystonia or dyskinesia, and in some cases can cause worse side effects. At least that's the information that's apparent from experiences of list members. If we knew then what we know now, we would have reduced Dick's Sinemet by at least a fourth at the same time he took his first Mirapex. Just a bit of advice from someone who's been there. About the deep brain stimulation surgery: Look in the archives under Pallidal Stimulation. I don't know if there's info in the archives under Sub-Thalamic Nucleus Stimulation, but that would be worth checking out, too. The thalamic stimulation recently approved by the FDA targets only tremor. The second-generation surgery is pallidal stimulation, which helps control tremor plus other PD symptoms such as dystonia and dyskinesia. I understand the third-generation surgery is stimulation of the sub-thalamic nucleus, which promises to control even more PD symptoms. Margie Swindler [log in to unmask]