Thanks, John. My mom takes Sinemet CR (25/100) about six times a day along with 1/4 of a regular Sinemet (10/100). Once or twice a day, she will take a small amount of mucuna instead of regular Sinemet along with the dose of Sinemet CR. Sometimes, if she wakes up early, she has one additional dose. This adds up to around 750-850mg/day of Sinemet.

Sometimes, the doses don't kick in at all and she gets no relief. She might get 3 hours or 4 hours of good time per day, maybe 5 if she is lucky. Her primary symptoms are rigidity, a slow gait, muscle weakness, and fuzzy-headedness (not dementia, she just feels like her thoughts are slower). She does not have a pronounced tremor. She also has some blood pressure fluctuations. She has disabling peak dose dyskinesias that include the sensation of restless legs, the actual jumping and moving of the legs, and acute shortness of breath (which is an uncommon but recognized form of dyskinesia). Slow digestion is a problem, too. She has lost a lot of weight with the PD and is trying hard to gain some back.

Agonists made the restless legs worse. Rytary didn't provide much relief and gave some stomach upset. Amantadine dropped her generally low blood pressure even lower, to the point that the doctor (movement disorder specialist) said she had to stop taking it. Your post prompted me to do some reading. I guess a COMT inhibitor might be the next thing to try?

I would appreciate any thoughts that you may be able to share. I am very grateful for the insights that I gain from this board. Thank you again!