Hi Kenki,
I'm in the UK also. It would be good if you could see a neuro who really knows about PD, but if that is not possible do you have access to a Parkinsons Nurse Specialist? They are the people who see the problems on the ground, and in the home, rather than in a clinic setting, and mine has been just brilliant.

When I referred to 'uptake of sinemet in the brain' I was specifically referring to the sinemet you take not actually being converted in the brain. This can happen, leaving you effectively undermedicated regardless of what you are taking - and entacapone, a COMT inhibitor, helps with this - don't ask me right now what COMT is, I'm no scientist! The main thing is that it gets the sinemet working where it is needed.

Balancing meds is indeed one of the biggest problems we have. I was getting a lot poorer results from sinemet than I realised, and had some of the things you describe, and just put it down to the condition, a bit fatalistically, until my meds were adjusted, and the difference is incredible.
I was given a couple of choices on which way to go, and went with the entacapone, which gave almost instant improvement, but took some getting used to.......

Check with your neuro that it is ok to take the domperidone with the other meds, if it is then you should give it a try, I know people who had exactly the same hesitance over using it as you do - it is very effective with both vertigo and nausea, and you should be able to reduce it slowly after a little time and come off it completely.

Sounds like the rasagiline upset the balance you had achieved. Something worth remembering with PD is that it can take a while for a new regime to settle down and be effective, whether or not you feel that you are responding.

Another possible avenue of help is the PDS helpline............

Lindy