Before making any changes or modifications to your current Parkinson’s medication regimen, you should consult your physician or health care professional. The user maintains full responsibility to administer medications or perform medical tests at the appropriate times. Use of an e-pill Medication Reminder is only a supplement to any memory system that you currently use to remind yourself to take medications or perform medical tasks.
Parkinson's Disease & Levodopa
Within four to six years of treatment with levodopa, the effects of the drug in
many patients begin to last for shorter periods of time (called the Wearing Off
effect) and the following pattern may occur:
Patients may first notice slowness (bradykinesia) or tremor in the morning before the next dose is due.
Less commonly, some experience painful dystonia, muscle spasms that can cause sustained contortions of various parts of the body, particularly the neck, jaw,
trunk, and eyes and possibly the feet.
Patients must increase the frequency of levodopa doses. This puts them at risk
for dyskinesia (the inability to control muscles), which usually occurs when
the drug level peaks. Dyskinesia can take many forms, most often uncontrolled
flailing of the arms and legs or chorea, rapid and repetitive motions that can
affect the limbs, face, tongue, mouth, and neck. Dyskinesia is not painful, but
it is very distressing.
In some people, eventually L-dopa is effective only for one to two hours and
most patients start to experience motor fluctuations. In about 15% to 20% of
patients such fluctuations become extreme, a phenomenon known as the on-off
effect, which consists of unpredictable, alternating periods of dyskinesia and
immobility. Sometimes the symptoms switch back in forth within minutes or even
seconds. (The transition may follow such symptoms as intense anxiety, sweating,
and rapid heartbeats.)
To reduce the effects of fluctuation and the wearing-off effect, it is important
to maintain as consistent a level of dopamine as possible. Unfortunately,
levodopa is poorly absorbed and may remain in the stomach a long time. Two
strategies have been suggested to take care of these problems:
A liquid form of Sinemet which may produce fewer fluctuations and a prolonged
"on" time compared with the tablet.
Source: A.D.A.M Inc., Well-Connected series, March 31, 2003. Well-Connected reports are written and updated by experienced medical writers
and reviewed and edited by the in-house editors and a board of physicians who
have faculty positions at Harvard Medical School and Massachusetts General
Hospital. Neither institution (HMS or MGH) nor e-pill, LLC reviews or endorses their content.
American Parkinson's Disease Association
1250 Hylan Blvd.
Staten Island, NY 10305
1-800-223-APDA (2732) www.apdaparkinson.com
National Institute of Neurological Disorders and Stroke
P.O. Box 5801
Bethesda, MD 20824
1-800-352-9424 www.ninds.nih.gov
National Parkinson Foundation Inc.
1501 N.W. 9th Ave. (Bob Hope Road)
Miami, FL 33136-1494
1-800-327-4545
in Florida: 1-800-433-7022 www.parkinson.org
Parkinson's Disease Foundation, Inc.
650 W. 168th St.
New York, NY 10032
1-800-457-6676
Parkinson's Institute
1170 Morse Avenue
Sunnyvale, CA 94089-1605
(408) 734-2800
Parkinson’s Resource Organization
74-090 El Paseo, Suite 102
Palm Desert, CA 92260-4135
Telephone: (760) 773-5628
Toll-Free: 1-877-775-4111
Fax......: (760) 773-9803
PRO Web site: www.parkinsonsresource.org
Parkinson's Support Groups of America
11376 Cherry Hill Road, No. 204
Beltsville, MD 20705
301-937-1545
United Parkinson Foundation
833 W. Washington Blvd.
Chicago, IL 60607
(312) 733-1893
e-mail: upf_itf@msn.com
e-pill, LLC is not a Medicare Provider and does not bill Medicare. If you are a Medicare recipient you assume complete financial responsibility for your purchases. e-pill®, HIProtector® are registered trademarks.