Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Medication ’wearing off’ a bigger problem for Parkinson’s patients than physicians may realize

24.10.2003


Patients with Parkinson’s disease (PD) who are taking levodopa therapy – the most widely-used agent to treat the illness – may experience the effects of their medication “wearing off” sooner than their health care providers realize. New data presented Oct. 19 at the Parkinson’s Study Group meeting in San Francisco concluded that a specifically-designed patient questionnaire identified symptoms related to “wearing off” more frequently than a clinical assessment by a movement disorder specialist.

“Although levodopa remains the foundation of Parkinson’s disease therapy, the medical community has long recognized that its use can be limited due to the inability to control Parkinson’s disease symptoms over time,” said investigator Robert A. Hauser, M.D., M.B.A., director of the Parkinson’s Disease and Movement Disorders Center of the University of South Florida in Tampa and member of an international consortium of researchers known as the End-of-Dose Wearing Off (EODWO) Working Group. “However, this study shows that end-of-dose ‘wearing off’ may be a bigger problem for Parkinson’s disease patients than physicians and other members of the health care community realize.”

Within one to two years, almost 50 percent of PD patients receiving levodopa therapy begin to notice that their medication lasts for shorter periods, causing symptoms to re-emerge before the next dose. This phenomenon is known as “wearing off.” Eventually, the effect of a levodopa dose may decrease from eight hours when patients begin levodopa therapy to only one to two hours. “Wearing off” is associated with the re-emergence of motor symptoms (e.g. tremor and problems with balance), non-motor symptoms (e.g. anxiety, fatigue, mood changes, and restlessness), and autonomic nervous system dysfunction (e.g. sweating and hypersalivation).



“To date, the frequency of end-of-dose ‘wearing off’ in a general neurology practice is unknown, and no specific tools exist to aid clinical diagnoses of its signs and symptoms,” said Dr. Hauser. “Because there are new medications available that can help to improve symptom control throughout more of the day, it is important for physicians to have a simple way to identify these symptoms.”

A group of 10 international Movement Disorder specialists (the End-of-Dose Wearing Off Working Group) collaborated to assess prospectively whether or not a specifically designed patient questionnaire can identify the same or more subjects suffering from end-of-dose "wearing off" than a clinical assessment. The blinded study used the AliProject, a web-enabled database of patients treated at participating Parkinson’s disease research centers in the United States. The clinical database was developed by the Muhammed Ali Parkinson Research Center.

Three hundred patients diagnosed with Parkinson’s disease participated in the study. All were age 30 or older, and had Parkinson’s disease for less than 5 years. Of the 289 patients who completed the study, 87.5% were on levodopa therapy versus other anti-parkinsonian medications. The duration of levodopa therapy for these patients was 1.96+1.53 years.

Investigators found that the clinical assessment identified “wearing off” in 85 patients (29.4%) compared with 165 patients (57.1%) who self-reported symptoms of “wearing off” on the patient questionnaire. When asked about difficulties associated with these symptoms, 40% of respondents indicated that the symptoms were at least very troublesome. The most commonly listed troublesome symptoms included tremor, balance difficulty, and reduced dexterity.

Parkinson’s disease, a chronic and progressive neurological condition, affects approximately 1.5 million Americans. Symptoms include limbs that tremble; slowness of movement; stiffness and rigidity of limbs, and gait or balance problems. As the disease progresses, these symptoms usually increase and impact a person’s ability to work and function.

Marissa Emerson | University of South Florida
Further information:
http://www.hsc.usf.edu

More articles from Health and Medicine:

nachricht Researchers release the brakes on the immune system
18.10.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht Norovirus evades immune system by hiding out in rare gut cells
12.10.2017 | University of Pennsylvania School of Medicine

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Neutron star merger directly observed for the first time

University of Maryland researchers contribute to historic detection of gravitational waves and light created by event

On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...

Im Focus: Breaking: the first light from two neutron stars merging

Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.

Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....

Im Focus: Smart sensors for efficient processes

Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).

When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...

Im Focus: Cold molecules on collision course

Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.

How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...

Im Focus: Shrinking the proton again!

Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.

It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ASEAN Member States discuss the future role of renewable energy

17.10.2017 | Event News

World Health Summit 2017: International experts set the course for the future of Global Health

10.10.2017 | Event News

Climate Engineering Conference 2017 Opens in Berlin

10.10.2017 | Event News

 
Latest News

Terahertz spectroscopy goes nano

20.10.2017 | Information Technology

Strange but true: Turning a material upside down can sometimes make it softer

20.10.2017 | Materials Sciences

NRL clarifies valley polarization for electronic and optoelectronic technologies

20.10.2017 | Interdisciplinary Research

VideoLinks
B2B-VideoLinks
More VideoLinks >>>