Levodopa - epgonline.org

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ENT416_NURSES LEAVEPIECE.qxd 2/10/06 14:08 Page 7 The typical pattern of wearing-off • Wearing-off: – Is associated with motor symptoms such as tremor, rigidity and muscle cramps, and non-motor symptoms such as anxiety, fatigue and slowness of thinking – Occurs in up to 40% of patients within 2 years 1 – Is often detected later than it should be: • Patients often take a dose of levodopa just before they see their nurse or doctor so their symptoms are well-controlled • Doctors often focus on more visible concerns • Patients might not link subtle wearing-off symptoms to being associated with their PD (e.g. anxiety, pain) • Anxiety related to being told of disease progression may prevent patients from openly discussing their symptoms with their doctor [1] Parkinson Study Group. JAMA 2000; 284: 1931–8
ENT416_NURSES LEAVEPIECE.qxd 2/10/06 14:08 Page 8 Recognizing the end result of pulsatility: wearing-off Nearly half of all patients reporting wearing-off are not diagnosed 1 48% Diagnosed by patients questionnaire only Diagnosed by physician questionnaire 52% Questions filled out individually by 300 patients and examining physicians. In some instances, wearing-off diagnosed by the physician was also diagnosed by the patient. [1] Stacy et al. Mov Disord 2005; 20: 726–33
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Levodopa - epgonline.org

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