This work may not be copied, distributed, displayed, published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the publisher’s Terms & Conditions.

CME eReport

Pharmacology and Evidence-Based Strategies for Current and Emerging Treatments for OFF Periods in Parkinson Disease

Rajesh Pahwa, MD, and Stuart H. Isaacson, MD

Published: December 1, 2020

Parkinson disease (PD) is a progressive neurodegenerative disease characterized by motor symptoms such as rigidity, resting tremor, and slowed movement in addition to nonmotor symptoms. As the disease advances and a patient’s response duration to a levodopa dose is shortened, OFF episodes become more prevalent, negatively impacting their quality of life. Clinicians may employ a variety of therapeutic strategies to reduce OFF time, such as altering the levodopa dose or initiating adjuvant therapy. Medications to treat daily OFF time include dopamine agonists, MAO-B inhibitors, COMT inhibitors, amantadine ER, and adenosine A2A antagonists; as-needed rescue therapies include subcutaneous apomorphine, apomorphine sublingual film, and orally inhaled levodopa; and, when necessary, advanced therapies such as carbidopa/levodopa enteral suspension or DBS may be indicated.

To cite: Pahwa R, Isaacson SH. Pharmacology and evidence-based strategies for current and emerging treatments for OFF periods in Parkinson disease. J Clin Psychiatry. 2021;82(1):SU19004BR2C.
To share:

© Copyright 2020 Physicians Postgraduate Press, Inc.

From the University of Kansas, Kansas City (Dr Pahwa); and Parkinson’s Disease and Movement Disorders Center of Boca Raton, Florida (Dr Isaacson)

See the entire activity

Volume: 82

Quick Links: Psychiatry


Sign-up to stay
up-to-date today!


Already registered? Sign In

Case Report

Safety and Tolerability of Concomitant Intranasal Esketamine Treatment With Irreversible, Nonselective MAOIs: A Case Series

Three cases suggest that concomitant use of intranasal esketamine with an irreversible, nonselective MAOI is safe in...