Would just like to drop this into the argument on sinemet, as someone whose sole dopaminergic treatment has been those little yellow tablets, without which I do not function...... after 40-50 years of knowing about this medication and some of the ways it reaches the brain, and what downsides there are, nobody has even approached a truly humane and practical way to drip feed us with levodopa. It has been well known for many years that a low and constant dose will alleviate many problems of PD and prevent the side effects of throwing into an already compromised system a whole lot more dopa than it needs. At best there is duodopa which some may find problematic though it is reported to be a great improvement, at least there is the home made solution of sinemet in orange drink that can be sipped. In between these there are a lot of other expensive medications which cost a small fortune. No attempts to balance neurotransmitters, in fact often no discussion. And an awful lack of imagination..... It is a useful drug that has been wildly prescribed for some, and is not properly understood by some people who prescribe it. There has been a huge information gap at point of initial prescription to new patients. Also a huge amount of fear-mongering that has led to agonists being prescribed just as wildly, these have side effects as bad and in some cases worse than dopa, as they not only undermine the patient physical, but mentally, socially, and in their relationships. I would defend sinemet - it works for me and gives me a better quality of life - on the grounds that is is a very useful drug. But you just cannot ignore the downsides. Nor the down sides to other PD medication.

Have to agree with Laura that evidence to date is point to the fact that there is disregulation rather than deficiency happening, and that dopa loss is just the start of that process....

Lindy