Managing Dyskinesia: Effective Treatment Strategies

Addressing dyskinesia can be complex, depending on its severity. Some patients consider discontinuing levodopa, as many experts believe it significantly contributes to the condition. However, stopping levodopa can lead to the recurrence of symptoms like tremors, stiffness, and rigidity, often requiring adjustments in medication doses. Striking the right balance is crucial, and some individuals may need prolonged periods without levodopa, which can be challenging. Others prefer to continue medication to prevent severe Parkinson’s symptoms, despite the risk of dyskinesia.

Various treatment options exist to manage dyskinesia effectively.

Medication

Utilizing controlled-release formulations of levodopa can help minimize peak-dose effects, reducing dyskinesia. Dividing the daily levodopa dose into smaller, more frequent intakes can also enhance symptom control. Medications that slow levodopa breakdown, such as certain inhibitors, may extend its therapeutic effects. Increasing dopamine agonists while lowering levodopa doses is another strategy. Additionally, a levodopa and carbidopa gel applied directly to the small intestine helps stabilize dopamine levels for smoother motor control. Amantadine, a glutamate antagonist, is effective in regulating glutamate, which influences dopamine, and can be administered orally or intravenously.

A motor diary is a helpful tool for tracking medication effectiveness and symptom fluctuations. Recording the timing of medication, meals, and symptom onset provides valuable insights for physicians to optimize treatment plans. Notably, protein-rich meals can interfere with levodopa absorption, so timing medication intake appropriately—such as taking it before meals or delaying protein consumption until later—may improve efficacy. Consulting with a healthcare provider is recommended before making dietary adjustments.