Diagnosing Wearing Off

Wearing-off, which is when the effects of levodopa fade out, is generally diagnosed by clinical evaluation by the doctor, using a detailed patient history as the cornerstone of diagnosis.

The diagnosis of wearing-off is often challenging. In the early stages, symptoms of wearing-off may still be subtle and do not necessarily appear every day, which can make it difficult to recognize what is happening. Symptoms also vary greatly between individuals. Non-motor symptoms, such as anxiety or depression, are more difficult for the doctor to identify than symptoms affecting movements.   

Open discourse with your doctor is important for the diagnosis of wearing-off, as doctors may miss the symptoms during the visit if they are well controlled at the time of the consultation. It is important to discuss your symptoms with the doctor and highlight any changes that may have occurred since the last visit¹⁰.

How can you help with the diagnosis of wearing-off?    

Identification of wearing-off, when the effect of levodopa starts fading out, relies on good communication between you and your doctor. There are some tools that may help you to identify the symptoms.


Wearing-Off Questionnaire

A question card called the ‘Wearing-Off Questionnaire’ has been designed specifically to help the doctor recognize when the effect of levodopa starts fading out and wearing-off develops in people with Parkinson’s disease.  

The questionnaire allows people with Parkinson’s disease to identify troublesome symptoms and indicate whether these symptoms disappear with the next dose of their medication. The question card can then serve as a point of reference for the doctor to discuss these symptoms in more depth and to make a diagnosis accordingly.