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Debbie- My Mom is also tremorless and has now been on permax for couple of weeks. I don't notice any deterioration in her voice. If anything it has improved, but probably from other factors - I noticed slur when she was still taking Amantadine and when hospital ignored proper Sinamet timing. Also she currently has good speech therapy which is teaching her a few tricks. emily ([log in to unmask]) for Mom 76/4 months nyc