Terms to Describe Wearing Off

On-time

'On'-time is the time when you find that your levodopa-containing medication is having benefit, and your parkinsonian symptoms are generally well controlled

Off-time

 'Off'-time is when your levodopa-containing medication is no longer working well for you, and your parkinsonian symptoms have returned, resulting in symptoms such as slowness, stiffness or tremor; and sometimes total (akinesia) or partial (bradykinesia) immobility

Wearing-off

Wearing-off is where you begin to feel that the improvement gained from a dose of levodopa medication gradually fades off and does not last until the time that the next dose of medication is due or begins to work (this feeling has often been likened to a car gradually running our of petrol). You may therefore feel that you need your next dose of medication sooner

Delayed on

Delayed 'on' is when there is an increased delay after taking your levodopa medication before you begin to feel the benefits. This may be more common with controlled-release preperations of levodopa, as they can take some time to dissolve in the stomach, enter the blood stream and travel into the brain in sufficient quantities to replace the missing dopamine

On-off phenomenon

The on-off phenomenon refers to sudden, sometimes unpredictable, changes in your symptoms, varying between mobility (usually with dyskinesia) and immobility due to the return of parkinsonian symptoms. These sudden fluctuations can have no apparent relationship to medication timing

Freezing episodes

Freezing episodes are sudden, brief (seconds to minutes) periods of immobility where you may find your feet 'stuck to the spot', as if they are glued to the floor. Freezing most often occurs when trying to initiate walking, whilst turning in confined spaces, or when going through doorways