You may have been at the doctor's office and been asked about your "off" time. It is often assumed by practitioners working with people with PD that they know about “on” and “off“ time. Off time refers to a down time when PD medication is not working optimally. During this time, your PD symptoms can come back and make it harder to move.
Not everyone has these on and off times. It depends on how long you have had PD and medications that you use to manage your PD symptoms. For those who have "off" times, it usually involves a return of a tremor, increased muscle cramping (dystonia), and/or stiffness in the trunk and limbs. Lesser considered symptoms are the non-motor symptoms of PD which can include increased anxiety or fogginess of thought.
How to manage "off" time
- Stay as close to a schedule as you can with your levodopa medication. This may mean setting an alarm in your phone as a reminder.
- If there is something you really want to do, try and schedule it during your "on" time.
- Try to avoid taking your levodopa with a meal, especially one that is high in protein. This can impact how your medication is absorbed by your body.
- Journal your day. If you are noticing times of day with more PD symptoms, try and keep track of where you are in your medication — if you just ate, how you slept, etc. All of these factors of life can impact how your body uses your medication.
- If you are in physical therapy, it can be helpful to have at least one of your sessions during this "off" time to work on developing strategies to help you stay moving.
- Talk to your doctor about these times. There are several medications that can be prescribed that target more unpredictable "off" times such as apomorphine, or a levodopa inhaler.