Waters CH et al. - There are several pharmacologic options to minimize the "wearing-off" phenomenon, including adjustment of levodopa treatment, the use of long-acting dopamine agonists, monoamine oxidase type B inhibition, or catechol-O-methyl-transferase inhibition in combination with levodopa. Dopamine agonists may reduce levodopa requirements. Monoamine oxidase type B inhibition can increase dopamine availability by preventing its metabolism. Similarly catechol-O-methyl-transferase inhibitors can increase the half-life of levodopa and the amount available to cross the blood-brain barrier by preventing its breakdown. The selection of a treatment for the management of "wearing off" should consider the relief of symptoms and also the potential adverse effects of adjunctive therapy.
See all
