GeneralParkinson’s Disease OFF Episodes

Parkinson’s disease (PD) is a progressive neurological disease that affects people of all ages. It causes slowed movements, muscle rigidity, and tremors, among other motor symptoms. It can also cause non-motor symptoms like anxiety, fatigue, and concentration problems.

In this article, Dr.Gurmeet Sawhney, one of the best neurosurgeons in Mumbai, has discussed Parkinson’s Disease OFF episodes.

Levodopa is the gold standard treatment for Parkinson’s disease.

Carbidopa improves the effectiveness of levodopa.

However, most people who receive this treatment develop OFF episodes as their symptoms return or worsen over time.

Please continue reading to learn more about OFF episodes and how to deal with them.

What is Parkinson’s disease‘s ON/OFF phenomenon, according to Dr. Gurneet Sawhney?

When someone with Parkinson’s disease has a flare-up of symptoms between levodopa doses, this is known as the ON/OFF phenomenon.

The levodopa is working well during an ON episode, and symptoms are improving. The levodopa isn’t working during an OFF episode, and symptoms return or worsen.

According to Dr.Gurneet Sawhney, 25 to 50 percent of Parkinson’s disease patients experienced OFF episodes within two years of starting levodopa treatment.

Most people with PD had OFF episodes within ten years of starting treatment.

OFF episodes can have a variety of effects on different people. They may also follow a predictable pattern or occur at random. They can come on quickly or gradually.

In a survey conducted in 2021, researchers discovered that OFF episodes were linked to lower quality of life in people with Parkinson’s disease.

OFF episodes can make it challenging to move around and perform daily tasks. They’re also linked to higher levels of anxiety and depression.

What are the causes of OFF episodes?

To fully comprehend the cause of OFF episodes, more research is required. Fluctuations in dopamine levels, according to experts, are a factor.

Dopamine is a neurotransmitter that helps nerve cells communicate. Dopamine deficiency is linked to PD symptoms.

Your body converts levodopa into dopamine when you take it. This helps to alleviate Parkinson’s disease symptoms.

Your dopamine levels start to fall as each dose of levodopa is used up. An OFF episode could result from a drop in dopamine.

Many people with Parkinson’s disease also have gastrointestinal issues that make it challenging to absorb oral medications.

If you take oral levodopa, your body may take some time to absorb the medicine. This could result in a postponed ON episode.

Is it possible to avoid an OFF episode?

Most people with Parkinson’s disease experience OFF episodes at some point.Some people are more prone to OFF episodes than others.

High doses of levodopa have been linked to an increased risk of OFF episodes, according to research. It may cause your dopamine levels to fluctuate more dramatically.

Your doctor should prescribe the smallest amount of levodopa that will help you manage your symptoms.

This may reduce your risk of OFF episodes by limiting dopamine fluctuations.

Let your doctor know if you suspect you’re having OFF episodes. They may change your levodopa/carbidopa dosage or formulation. Other treatments for OFF episodes may be prescribed as well.

What are your strategies for dealing with OFF episodes?

If you’re having OFF episodes, your doctor may suggest making one or more treatment changes.

They could adjust your oral levodopa/carbidopa dose or formulation as needed.

They may prescribe lower and more frequent oral levodopa/carbidopa doses.

They may choose an extended-release formula over a fast-acting one.

Enteral levodopa/carbidopa is recommended.

To provide a steady stream of medication, this type of carbidopa/levodopa is infused continuously through a pipe into your abdominal region.

The tube must be inserted through surgery.

Prescribe a maintenance medication as a supplement. Including one or more adjunct medications in your daily treatment plan may help you get better symptom relief during ON episodes.

It may also reduce the number of OFF episodes and their duration.

Prescribe a life-saving medication. When OFF episodes occur, a quick-acting rescue medication such as sublingual apomorphine strips may be helpful. You don’t take rescue medications regularly; instead, you use them only when they’re needed.

Your doctor may recommend deep brain stimulation in some cases (DBS).

According to Dr.Gurneet Sawhney, a surgeon places electrodes in the brain and a small internal pulse generator in the chest or abdomen during this procedure.

The inner pulsation generator transmits electrical signals to the brain to help regulate DB symptoms.

Every treatment alternative comes with its own set of potential side effects.

Inquire with your doctor about the potential benefits and risks of various treatment options.

Conclusion

When the medication levodopa/carbidopa fails to work correctly, most people with PD experience OFF episodes, in which their symptoms return or worsen. These occurrences can harm one’s quality of life.

Let your doctor know if you think you’re having OFF episodes.

For instance, reach them if you wake up with troubling signs or if signs return or worsen between levodopa/carbidopa doses.

Let them know if a dose of levodopa/carbidopa takes a long time to provide relief.

They may change your levodopa/carbidopa dosage or formulation. They may also prescribe treatments on an as-needed basis to help prevent and relieve symptoms associated with OFF episodes.

This is a sponsored post