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Rescue Me: On-Demand Treatments for Sudden Parkinson's 'Off' Episodes
Published: Sep 29, 2024
For people with Parkinson's, sudden 'off' episodes can be like getting stuck in quicksand. On-demand rescue treatments offer a lifeline, providing quick relief when regular medications aren't enough.
Apomorphine Injections
Apomorphine is a powerful medication that can be injected under the skin for rapid relief. It's like having a fire extinguisher on hand - quick to use in an emergency. The effects typically start within 10 minutes and can last for about an hour. While effective, it can cause side effects like nausea, so it's often used with an anti-nausea medication, at least initially.
Inhaled Levodopa
A newer option is inhaled levodopa powder. This allows the medication to be absorbed through the lungs, bypassing the digestive system. It's like using an asthma inhaler, providing a quick boost of medication. Effects can be felt in as little as 10 minutes. However, it requires good lung function and the ability to use the inhaler correctly.
Sublingual Apomorphine
Another form of apomorphine comes as a thin film placed under the tongue. It dissolves quickly, allowing for rapid absorption. This is like a fast-dissolving breath strip, but for Parkinson's symptoms. It can be easier to use than injections for some people, but may cause irritation in the mouth.
Choosing and Using Rescue Treatments
The choice of rescue treatment depends on factors like the severity and frequency of 'off' episodes, other medical conditions, and personal preference. It's like choosing between different types of umbrellas - you want one that's easy for you to use when caught in a sudden downpour. These treatments are meant to complement, not replace, regular Parkinson's medications.
Frequently Asked Questions
It varies, but typically up to 5 times daily; always follow your doctor's instructions.
No, effectiveness can vary; they work best for those who still respond to levodopa.
They're not addictive, but overuse can lead to increased dyskinesia.
They're designed for sudden 'off' episodes, not regular use.
Usually not, but always consult your doctor about your overall treatment plan.
A Safety Net for Symptoms
On-demand rescue treatments provide a valuable tool for managing sudden 'off' episodes in Parkinson's disease.
References
- Olanow CW, Factor SA, Espay AJ, et al. Apomorphine sublingual film for off episodes in Parkinson's disease: a randomised, double-blind, placebo-controlled phase 3 study. Lancet Neurol 2020; 19:135.
- LeWitt PA, Hauser RA, Pahwa R, et al. Safety and efficacy of CVT-301 (levodopa inhalation powder) on motor function during off periods in patients with Parkinson's disease: a randomised, double-blind, placebo-controlled phase 3 trial. Lancet Neurol 2019; 18:145.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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