As Parkinson’s care partners know well, everyone living with Parkinson’s experiences OFF times differently. (OFF times occur when their medication wears off, hasn’t kicked in, or just isn’t providing symptom relief.) For some, especially those who have been diagnosed for only a few years, OFF periods may be rare and a minor concern. For others, OFF can be a frequent and debilitating experience. No matter what stage of Parkinson’s your loved one is in, you can help them navigate OFF times so they can get back to feeling their best.
Although the terms ON and OFF have been used to describe responses to levodopa therapy for more than 40 years, there is still no universally agreed-upon definition for the term OFF, and everyone with Parkinson's experiences it differently. OFF periods occur when your medication isn't working optimally, and your motor and non-motor symptoms return. OFF is much more nuanced but understanding its scientific causes can help you minimize it in your daily life.
Dr. Cherian Karunapuzha explains how drinking a glass of water when you take your levodopa helps "flush" the medicine from your stomach to your small intestine, where it is absorbed. Drinking a glass of water and taking your levodopa on an otherwise empty stomach will ensure that more of the medication is absorbed, giving you the full benefit of the levodopa.
Dyskinesia is an uncontrolled, involuntary muscle movement. Although it can be a stand-alone condition, in people with Parkinson’s, it is most often associated with long-term use of levodopa. Common symptoms of Parkinson’s dyskinesia include writhing or wriggling, fidgeting, rocking, and head bobbing.
Although many symptoms can occur in Parkinson’s, the most common motor symptoms are tremor, stiffness, and slowness. In this webinar, Dr. Aaron Haug, Neurologist and Movement Disorders Specialist with Blue Sky Neurology in Englewood, CO, discusses treatment strategies and explains in detail the specific medications used to treat the motor symptoms of Parkinson’s.
Learn some shortcuts for communicating more effectively about OFF times.
In this article, Dr. J. William Langston answers the most common questions about Parkinson’s Disease Dyskinesia.