Table 2.

Fluctuations of Levodopa Rx

• wearing off  symptoms that typically respond to treatment become more manifest before the next dose is administered

• on-off fluctuations  exacerbation of symptoms that do not correlate with specific dose times

• night-time deterioration  in moderate-to-severe disease, manifested as frequent urination, difficulty rolling over in bed, or muscular aches

• early morning deterioration  many patients experience their most severe PD symptoms upon waking in the morning