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Sinemet has both an acute and chronic effect. The acute effect: Each pill gives the PWP what we recognize as "On" and "Off" several times a day in some cases. However, there is also a chronic effect to the drug. The chronic effect: As one increases or decreases the Sinemet dose, it takes a while to arrive at a new balance. Increased doses tend to have an increasing effect for up to six months -perhaps even longer. This is recognized as lighter "Off" periods and the "On" tending to string together again. Decreased doses at first tend to increase the amount of off time in the ensuing days. With further time on a lowered daily intake (in terms of weeks usually) off time tends to decrease again and establish a chronically lower level of function and side effects. The lower level sort of begins to take up the slack and make again a mobile situation. Off time again decreases. This chronic effect happens very slowly The "Drug holiday"(stopping all drugs) - a dangerous and painful experience not to be taken lightly- exaggerates and shows these things more clearly. Hope this helps. Regards, WHH 54/18