Bonnie-- Mirapex is an agonist, which "mimics" the action of Sinemet without adding more actual dopamine. I can be used either alone (early stages) or along with Sinemet, with care NOT to overdose in the combination---Sinemet is usually reduced when adding the agonists of which Mirapex is one. Actually it was a number of years before Peter npoticed "on-off" symptoms--but that varies like everything else about PD! Camilla Flintermann, CG for Peter 81/70/55 Oxford, Ohio http://www.newcountry.nu/pd/members/camilla/one.htm <[log in to unmask]> "Ask me about the CARE list for Caregivers of Parkinsonians ! "