Your doctor may consider a number of ways to manage or treat OFF, dyskinesia or both.

Adjusting levodopa

This approach involves changing how much levodopa you take and how often you take it. Treatment strategies that adjust or limit levodopa therapies often result in a person with PD faced with a “trade-off”: either accept OFF or dyskinesia.

Oral medication

There are oral medications that may be used to treat OFF, dyskinesia or both.

Surgery

Deep brain stimulation (DBS) or levodopa carbidopa gel implanted in the intestines may be considered, especially if medications cannot control symptoms well enough. For some people who have already had either of these surgical options but dyskinesia remains a problem, oral medications may also be an option (refer to “Oral medication” section).

Approximately 80% of people with dyskinesia also experience OFF so it is a delicate balance to address the symptoms of Parkinson’s OFF time with enough levodopa without triggering dyskinesia that happens as a result of high levels of levodopa medication.1, 2, 3

> Learn how to talk to your doctor about motor complications

Tips for making the most of your levodopa

  • Drink a full glass of water with your medication. This allows the drug to fully dissolve and move through the digestive tract.
  • Take your medication at least 30 minutes before or 1-2 hours after a meal.
  • If you experience nausea, try a light low-protein snack, such as dry bread, soda crackers, or a piece of banana If the nausea does not resolve, call your doctor. You may need supplemental carbidopa to help resolve this side effect.4
Talk about more tips with your support group
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References

1 Olanow CW, Kieburtz K, Rascol O, et al. Factors predictive of the development of Levodopa-induced dyskinesia and wearing-off in Parkinson’s disease. Mov Disord. 2013;28(8):1064-1071.
2 Santos‐García, D., de Deus Fonticoba, T., Suárez Castro, E., Aneiros Díaz, A., McAfee, D., Catalán, M.J., Alonso‐Frech, F., Villanueva, C., Jesús, S., Mir, P., Aguilar, M., Pastor, P., García Caldentey, J., Esltelrich Peyret, E., Planellas, L.L., Martí, M.J., Caballol, N., Hernández Vara, J., Martí Andrés, G., Cabo, I., Ávila Rivera, M.A., López Manzanares, L., Redondo, N., Martinez‐Martin, P., McAfee, D. Non‐motor symptom burden is strongly correlated to motor complications in patients with Parkinson’s disease. Eur J Neurol. 2020. doi:10.1111/ene.14221
3 Hauser RA, McDermott MP, Messing S. Factors associated with the development of motor fluctuations and dyskinesias in Parkinson disease. Arch Neurol 2006;63:1756-60.
4 “Common Nutritional Concerns in Parkinson’s,” Parkinson’s Foundation. https://www.parkinson.org/Living-with-Parkinsons/Managing-Parkinsons/Diet-and-Nutrition/Common-Nutritional-Concerns-in-Parkinsons