I have 4GB in my Home Premium 64 box.
Overall it's a nice addition. My computer is a gaming rig, and the extra RAM is defenitely appreciated. Why?
For starters, Vista's Superfetch is quite agressive. So with 4GB, Superfetch has a lot of room to cache stuff up. Basically I never hit I/O when doing regular usage like web browsing or listening to music.
Also, with 2GB, some games like Company of Heroes were already hitting pagefile, even with all other applications closed. With 4GB, not only do I not need to close any other application when playing a game, I have ample memory left when the game's running to ensure I don't hit pagefile mid-game.
And also, since the OS doesn't need to dump all my memory to make room for the game before playing, going into the games and out of the games back into the desktop is much, much smoother. The actual game doesn't run any faster...but those bumps you get here and there when hitting the HDD mid-game are gone, of course.
All in all4GB is nice. Not essential but surely appreciated.
Just make sure your motherboard plays nice with 4GB (specially 4 sticks of RAM). Many claim they do but in reality their support is iffy at best.