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Levodopa
remains the cornerstone of any long-term Parkinson's
disease treatment plan. However, its ability to
control the symptoms of Parkinson's can become
reduced over the years. You may begin to experience
what is known as 'wearing-off' where your symptoms
begin to re-emerge before it is time to take your
next scheduled dose.
When experiencing 'wearing-off' you may notice
changes in your movement and mobility, thoughts
and feelings, sensations and your overall sense
of well-being.
For example, you may find that your Parkinson's
symptoms begin to re-emerge or become noticeably
worse before it is time to take your next scheduled
dose of medication. This re-emergence of symptoms
is called 'wearing-off'.
If you are concerned that you might be experiencing
"wearing off", an quick and easy way
to find out is by using the wearing-off question
card. If you answer one or more of the 19 symptom-related
questions with "I experience symptom"
and "symptom improves after my next medication
dose", it might be helpful to discuss "wearing-off"
with your doctor at your next visit.
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| What
is meant by treatment wearing-off? |
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Wearing-off
refers to the re-emergence or worsening of a
Parkinson's disease symptom, commonly occurring
two or more hours after a dose of levodopa medication.
These symptoms usually improve or resolve once
the next dose of levodopa medication takes effect.
Because
Parkinson's disease is a movement disorder,
attention has focused on problems with movement
- known as motor symptoms - as these are the
cardinal symptoms of Parkinson's disease and
can be easily identified.
Motor
symptoms include tremor, rigidity or muscle
stiffness and slowness of movement or 'bradykinesia'.
The
tools used by clinicians to identify wearing-off
during a clinical assessment mainly focus on
the return of these motor symptoms. However,
you may experience other symptoms when your
medication 'wears-off' that aren't related to
movement, and are consequently less obvious.
These symptoms of Parkinson's have been classified
as non-motor symptoms.
However,
you may experience other symptoms when your
medication 'wears-off' that aren't related to
movement, and are consequently less obvious.
These symptoms of Parkinson's disease have been
classified as non-motor symptoms. Non-motor
symptoms can include changes in thoughts and
feelings, sensations and sense of well-being
and changes in autonomic nervous system functions
(e.g. sweating). Although non-motor symptoms
may not be as obvious as motor symptoms, they
are no less important. On the contrary, non-motor
symptoms can actually be more bothersome and
disabling than motor symptoms.
Wearing-off
can include both motor and non-motor symptoms.
Your doctor may not recognize non-motor symptoms
of wearing-off as easily as motor symptoms,
because they can be quite subjective. Also you
may interpret these non-motor symptoms as being
part of the normal course of the disease and
may not recognize the link to medication doses.
You can help your doctor to identify non-motor
symptoms by providing a description of how and,
importantly, when these symptoms occur, to help
your doctor identify these symptoms, as they
can be improved if recognized and treated.
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