I'm no doctor, but here's how I'd go about analysing the situation.

The first thing that sticks out is that you're taking two COMT inhibitors: entacapone (in the Stalevo) and tolcapone (the Tasmar). Why?

To a first approximation your symptoms are likely to be caused by a lack of dopamine in the brain (bradykinesia) or a surplus (dyskinesias). So, ideally you would know what the levels are that work for you, what the levels actually are, and have a way of adjusting them back to the right level. Of course, PwP don't have access to this data and even if we did, for reasons such as protein in the diet and gastric emptying, the amount and timing of the arrival in the brain of levodopa (which to be of use needs to be converted into dopamine) varies.

As I understand current thinking the aim is to keep dopamine levels as constant as possible. The drugs we take need to be timed correctly so as to do this.

When comparing different medication regimes I find it useful to use the concept of levodopa equivalent dose. For instance, 75mg Stalevo is roughly equivalent to 100mg Sinemet.

For a list of exchange rates see:

http://neurotalk.psychcentral.com/thread183360.html

If you add together all the LED of the pills taken in a day, you get the levodopa equivalent daily dose (LEDD).

How does the LEDD before the change in the meds compare with that after?

Even if the LEDD after is the same as that before, we may still have problems due to the timing and intensity of the medications. For instance, 1mg rasagiline (Azilect) has a LED of 100mg, the same as Sinemet. But the rasagiline will be effective for 24hrs whereas, depending on the person, the Sinemet is effective between 2-4hrs. So, Sinemet is about 8 times more intense, but only acts for about 1/8th as long.

If you know how long your drugs work for you, you can draw a graph showing the contribution of each drug. If you don't know, you can use finger taps. See:

http://neurotalk.psychcentral.com/thread169655.html

John