Hi,

First let me say that you are not alone in the quest for the right med combo! I recently changed neurologists because my first one had me on way too much Sinemet, and she didn't want to work with me to alter meds. I was mildly dyskinetic but wanted to get off the crazy dosages because I felt I was courting disaster. In seeing the new doctor, I had to go in after being off all meds for 12 hours Please keep in mind:

1) Yes! You can lower your strength of Sinemet and dose more frequently. This is the idea behind Duodopa; an intestinal pump infusion of levodopa that is still in clinical trials here in the States, it gives a steady and lower dose that results in significant reduction of dyskinesias and near elimination of on/offs.

2)Have you thought of trying Sinemet CR? It's slow, controlled release over a longer period of time. It results in a steadier flow of levodopa minimizing the peaks and valleys- also almost eliminated my "dancing".

In my case, I found that Sinemet CR and a slight increase of my Mirapex has worked wonders! It has extended my on-time by 2 hours per dose. I also was able to significantly reduce the amount of levodopa I am taking per day. I just started this and so long as I avoid an "off"- I feel normal and it works well for me.

While we do have limited medications, we do have options on combining them- so hang in there! It is extremely frustrating finding the right balance, but your neuro should be on your side. Let him do the work for you in figuring out a basic regime and then see how you feel- adjust from there.

Laura