Here’s Why ‘Off Periods’ Can Be Dangerous for People with Parkinson’s


Dr. Benjamin Walter, of the Center for Neuro-Restoration at Cleveland Clinic, said that the average person isn’t accustomed to the strict regimen of multiple medications a day that’s part of everyday life for people with Parkinson’s.

“Most people feel burdened just taking an antibiotic, which can be difficult to remember. Now, imagine someone who has Parkinson’s — the minimal dosing is usually three times a day,” Walter said.

He explained that the need to frequently take medication is because it usually only lasts in a person’s bloodstream for 90 minutes.

“Once the medication gets into the brain, it’s converted to dopamine and stored in dopamine neurons, which recycles and reuses that medication over and over until it is depleted. Now, it’s not uncommon to have patients on meds four or five times a day,” he said.

Walter stressed that when discussing Parkinson’s and off periods, no two people are the same.


Parkinson’s is a highly variable disease. Some people will experience different motor symptoms and tremors than others.

For example, some people freeze when they walk, while others don’t.

He said the off periods can be terrifying for many people and also cause a different symptom — anxiety.

“You can suddenly become very anxious when the Parkinson’s medication wears off. It depends on what it is. If it’s a mobility issue in a patient, they should be more careful in noticing their medications wearing off and be careful about trying to do things that require dexterity and mobility,” he said.

Walter said that it’s important for those taking care of a person with Parkinson’s to understand how dangerous off periods can be.

“If you have a patient with Parkinson’s, you have to be aware that they can suddenly go from a state that is fully functional to an off state with very poor function,” Walter cautioned. “Now, that person is at risk for falls and choking on food and things that can be fatal.”

He stressed the importance of making sure patients get their medications on schedule “so that everything is kept in working order.”

He added, “If you’re starting to notice times when your meds aren’t working on a consistent basis, then you should be talking to your doctor about adjusting the medications.”