Stiff limbs and tremors might be familiar symptoms if you have Parkinson's disease. You may also have other movements you can’t control -- like swaying, head bobbing, or fidgeting. These are signs of a condition called dyskinesia.
Dyskinesia often happens when people take the Parkinson's drug levodopa. You're more likely to have these movements if you're on high doses of the drug or you've taken it for many years. It doesn’t happen to everyone, and for some people the symptoms are mild. For others, the movements can be uncomfortable, and they can interrupt your daily routine.
But there are treatments that can ease those symptoms. If you have dyskinesia, see the doctor who treats your Parkinson's disease. You might just need a simple change to the medication you take for Parkinson’s. Or you can take a new medicine to relieve these movements.
Change Your Levodopa Dose
Parkinson's symptoms happen when you don’t have enough dopamine, a brain chemical that helps your limbs move smoothly. Levodopa is a drug that raises the amount of dopamine in your brain. It prevents stiffness and jerky movements.
When you take levodopa, the amount of dopamine in your brain goes up. As the drug wears off, those levels drop. These up-and-down changes may be part of what causes dyskinesia.
One way to prevent the condition is to lower the dose of levodopa you take. The challenge is to lower it just enough to avoid this side effect but still take enough of the drug to control your Parkinson's symptoms. Your doctor can help you fine-tune your dose. They may also add other types of medications to your treatment.
Another option is to switch to an extended-release form of levodopa. The medicine releases more slowly into your blood to keep your dopamine level steadier.
Amantadine
Amantadine is a drug that treats dyskinesia in people with Parkinson's disease. It helps to ease symptoms like shaking and stiffness. There are two forms:
- Gocovri is an extended-release form. You take one capsule at night.
- Osmolex ER is another extended-release form. You take it once a day in the morning.
Amantadine can cause side effects like dizziness, nausea, and trouble sleeping. Discuss these and other side effects with your doctor before you start to take this medicine.
Another option your doctor may consider is clozapine.
Other Options
If medications don’t control your dyskinesia, there are other treatments you can try.
Deep brain stimulation (DBS) is a procedure that can treat Parkinson's symptoms. It can help with tremors, stiffness, and walking problems. DBS can also prevent dyskinesia.
During DBS, a doctor puts a small device -- similar to a pacemaker -- inside your brain. This device sends electrical signals to the parts of your brain that control movement. It blocks the abnormal nerve impulses that cause Parkinson's symptoms and dyskinesia. DBS can also mean that you may be able to take less levodopa, which could ease dyskinesia symptoms, too.
Your doctor might recommend DBS if:
- You've lived with Parkinson's disease for at least 4 years
- You have dyskinesia
- There are times when your medicine doesn't control your symptoms
DBS involves surgery. Although problems are rare, surgery can sometimes cause side effects, like:
- Bleeding in the brain that could lead to a stroke
- Infection in the brain
- Problems with the implanted device
- Sleepiness or personality changes, though these should go away after 1-2 weeks
Another option is to get a continuous infusion of medicine into your body through a battery-powered pump. There are two options:
- Levodopa/carbidopa intestinal gel (LCIG)
- Continuous subcutaneous apomorphine infusion (CSAI)
Talk about the pros and cons of each dyskinesia treatment option. Your doctor can help you choose the treatment that will work best for you with the fewest side effects.
