Dyskinesia: Understanding the Parkinson’s Med Side Effect | APDA

If you have Parkinsons disease, there is a good chance that youve been, or will be taking medication containing levodopa. Levodopa is administered in combination with the drug carbidopa (Sinemet and its generic versions). This drug combination is considered standard treatment for Parkinsons disease symptoms such as tremor, muscle stiffness, and slowness of movement. A side effect of long-term use of levodopa is dyskinesia. Below, you will learn about dyskinesia, what causes it, how it can be managed, and some basic coping strategies.

The features of dyskinesia include rapid, involuntary, and uncontrollable movements other than the tremors typical of Parkinsons. Dyskinesia can present as body swaying, writhing, twisting, squirming, arm flailing, fidgeting, or head bobbing. Dyskinesia initially appears on the side of the body most affected by Parkinsons. Although it can be localized to one part of the body such as the legs and arms, it can also spread to the torso, head, and neck. In rare circumstances, dyskinesia can also affect speech and respiratory and eye muscles.

Presenter: M. Maral Mouradian, MD, William Dow Lovett Professor of Neurology, Director, Center for Neurodegenerative and Neuroimmunologic Diseases Rutgers Robert Wood Johnson Medical School.

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Dyskinesia is a side effect of levodopa use. The underlying cause of dyskinesia is complex and is not completely known. Normal brain function depends on a complex network of cells that communicates and functions via an array of different brain chemicals. One of these chemicals is dopamine. In Parkinsons, there is a loss of brain cells called dopaminergic neurons that make dopamine; therefore, the level of dopamine in the brain starts to decrease. The purpose of taking levodopa is to temporarily restore the dopamine that is lost. However, since levodopa is intermittently taken over the course of a day, the level of dopamine will rise and fall. These dopamine level fluctuations, in combination with the loss of dopaminergic neurons, are thought to cause dyskinesia. Dyskinesia can occur when the level of levodopa in the body is at a maximum, referred to as peak dose dyskinesia, or when the levels of levodopa are rising or falling, referred to as diphasic dyskinesia.

At present, treatment with levodopa is the most effective way to relieve tremor, stiffness, and slow movement associated with Parkinsons. In the early stage of Parkinsons, levodopa may not be necessary and there are other medications available to treat this stage of the disease. However, as the disease progresses and symptomsbegin to interfere with daily living, your doctor will prescribe levodopa.

Once dyskinesia has started it is difficult to treat. However, there are several ways to delay it from starting or reduce it once it has begun.

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Dyskinesia: Understanding the Parkinson's Med Side Effect | APDA