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Fatigue connected with PD has been mentioned here often by listmembers, but the books and patient manuals have little or nothing to say about it. The following is from my own collection of unqualified opinions, idle speculation, and irresponsible rumors about diverse PD symptoms (all I can think of): STRESS: I haven't heard of professional agreement, but I believe that the need for dopamine replenishment increases with any kind of stress or strenuous activity, either physical or mental. Certainly, PWP find that motor symptoms become more pronounced during periods of stress, such as an argument or in preparation for any kind of trial. I think PWP are subject to a special sort of fatigue, that responds to dopamine. Chronic Fatigue: PWP often complain of constant tiredness or lack of energy, even in the morning after a restful night. "Chronic Fatigue Syndrome" is a recognized clinical condition, but I think it is unrelated to PD because it affects others as well. Ordinary fatigue or exhaustion follows prolonged strenuous exertion, such as an athletic contest or a difficult mountain climb, as muscles are depleted of chemicals that enable them to function, for example blood sugars and oxygen. Ordinary fatigue abates upon prolonged rest, which permits weary muscles to recover their normal chemical state. Quick Exhaustion: What some PWP call "Chronic Fatigue", I prefer to call "Quick Exhaustion". It is not due to running out of blood sugar or oxygen, but mimics the real thing with labored breath and rapid pulse, even in moderate exertion such as climbing a flight of stairs, or doing a tedious manual task. Ignoring this kind of fatigue may trigger pain in an unrelated area, such as the upper back. Its sudden onset and equally quick recovery, after a brief rest or an extra dose of levodopa, shows the connection with PD. In a treadmill test, the technician may notice the unusually quick "cooling off" of pulse and breathing rates. Cheers, Joe J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013