A fine balance: Achieving GOOD ON time

Adjusting or limiting levodopa therapies to treat OFF and dyskinesia reduce result in a “trade-off” where you either accept more OFF time to avoid having dyskinesia or accept dyskinesia to avoid OFF episodes. However, this is not the only option, and there are ways to avoid this trade-off, by reducing both your OFF time and dyskinesia without adjusting levodopa.

Maximizing levodopa therapy

Levodopa (LD)

Over time, it can be difficult to achieve GOOD ON time by adjusting levodopa.

Importance of maximizing GOOD ON time

Motor complications (including OFF and dyskinesia) were cited as the top symptoms affecting quality of life in a survey of people with Parkinson’s disease for at least 6 years.1

OFF time and dyskinesia can get in the way of all sorts of things.


Social events
Meetups with friends and family, birthdays, weddings, and other events may make you feel awkward or uncomfortable to be around other people because you don’t know when your OFF time or dyskinesia will flare up. Additionally, special events with other people can be stressful and cause more dyskinesia due to the anxiety, so you may opt to stay home.


Daily routine activities
Uncontrolled movements make simple tasks like walking, typing, signing your name, cleaning the house, texting, or calling a friend difficult. They can also make these tasks embarrassing, irritating, and time-consuming.


Hobbies you would normally enjoy like yoga, tennis, gardening, dancing, or painting may become difficult to do.


You may not feel confident in day-to-day work tasks or speaking on the phone, or you may want to avoid feeling embarrassed around co-workers.


You may not be able to enjoy meals without dreading an accidental food or drink spill, so you may avoid eating in public with family and friends.

“I can’t talk to John on the phone anymore. His dyskinesia makes his head turn from side to side so much. I only hear half of what he has to say.”

— Maria

Learn how to talk to your doctor about movement challenges


1 Politis M, Wu K, Mollot S, Bain PG, Chaudhuri RK, Piccini P. Parkinson’s disease symptoms. The patient’s perspective. Movement Disorders 2010; 25:1646-51