PATIENT AREA

Off Episodes

Off episodes are among the most frustrating and challenging complications of Parkinson's disease (PD). An off episode is a period of time during which PD symptoms reemerge despite taking PD medicines. Symptoms of an off episode may include muscle stiffness, slow movements, and difficulty starting movements.

The incidence of off episodes is relatively high in patients with PD who have used oral levodopa, and it increases with the length of time that they are on levodopa.

In studies:

• Up to 50% of patients who were treated with oral levodopa for 5 years or more experienced off episodes
• About 70% of patients who were treated with levodopa for 9 years or more experienced off episodes
• More than 90% of young-onset patients (people who were younger than 40 when they developed PD) who were treated with levodopa for 5 years experienced off episodes

Types of Off Episodes

Off episodes can be predictable or unpredictable:

End-of-dose wearing-off episodes

• Morning off episodes, or early-morning akinesia, as levels of PD medicines drop during the night
• Predictable wearing-off episodes as patients feel the effects of their medicines decreasing between doses

Unpredictable off episodes

• Delayed on episodes or dose failure as medicines take longer to take effect or fail to act at all
• Unpredictable on-off episodes during which patients may experience sudden shifts between on and off states

For an explanation of the use of APOKYN in the treatment of off episodes, click here.

To return to the "About APOKYN" page, click here.