I’m having episodes more and more frequently. I start the morning with 4 pramipexole sustained-release tablets and Madopark Quick. Then one Comtess and one Madopark every three hours. In the evening, two Sifrol and one Madopark sustained-release tablet. I tried rasagiline and felt absolutely terrible. Then I tried Xadago, which caused no side effects. But it had no effect. So the neurologist gave up, saying they had nothing more to offer.

If by ‘flare-ups’ you mean fluctuations in mobility that sometimes cause gaps in your medication, it might be time to consider ‘advanced treatment’, i.e. DBS, a pump or microtablets. Such treatment is likely to stabilise your symptoms much better than your current medication. Your neurologist may have meant that there were no other types of tablets to offer. There’s no need to ‘give up’; you can always adjust your existing medication, or resort to the ‘advanced’ methods.