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Because Parkinson's disease is a movement disorder, attention has focused on problems with movement. These are known as motor symptoms.
The tools used by doctors to identify levodopa “wearing-off” mainly focus on the return of these motor symptoms.
You may have other symptoms when your medication “wears-off” that have nothing to do with movement. These types of symptoms are known as non-motor symptoms.
Your doctor may not recognize the non-motor symptoms of levodopa “wearing-off” as easily as motor symptoms. You can help your doctor to identify non-motor symptoms by telling him or her how and when these symptoms occur.
What symptoms are associated with levodopa “wearing-off?”
Following is a guide to some of the symptoms that you may experience with levodopa “wearing-off.” The key to identifying “wearing-off” is to closely monitor any symptoms that you experience, especially those that usually improve after your next dose.
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Slowness of movement (bradykinesia) |
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Tremors |
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Feeling of internal tremors |
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Decreased manual dexterity |
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Inability to move (akinesia) in the early morning |
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Sudden muscle spasms (dystonia) |
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"Pins and needles" feeling (paresthesia) |
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Muscle pain |
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Voice softness |
When are you likely to experience levodopa “wearing-off?”
Parkinson's disease does not affect everyone in the same way. There is no way to tell if, or when, you might experience “wearing-off.” However, nearly half of patients experience “wearing-off” within two years of levodopa treatment. So, if you are taking levodopa, it is important to recognize the symptoms and talk to your doctor because there is a chance this might happen to you. Your doctor may already have determined that you were experiencing “wearing-off.” If so, he or she may have increased your medication.
What if you think you are experiencing levodopa “wearing-off?”
If you think you're experiencing levodopa “wearing-off,” discuss your changing symptoms with your doctor. There are medications available that can help manage the symptoms of “wearing-off.” Your symptom control is unlikely to get better on its own. It may get worse. Once “wearing-off” is identified, different treatments can be explored. The more information you give your doctor, the more options you will have to manage your symptoms.
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