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Sir James: My words can't be construed as advice because I am not a medical professional and can't lay claim to a wealth of experience because I am only coming to the end of my first year with the disease. However, (there always seems to be one), from everything I've read on this list and elsewhere, the better bet is to to titrate away from Sinemet rather than toward it, so long as you can do so without terribly affecting your quality of life. The idea being that for most (and apparently not for all) , the Sinemet too will get you over time so the longer the delay the longer it takes to get you. In the belief in this knowledge (which has been confirmed by both - count 'em - my Neuros) I am going in the other direction, increasing Requip and decreasing Sinemet. Regards, Paul H. Lauer