How to prevent switching of medication in Parkinson’s disease patients?

  Parkinson’s disease is due to degenerative lesions of the nervous system, resulting in involuntary movement of the limbs, affecting the work and life of patients. Once symptoms are detected, prompt medical treatment is required. After the diagnosis of Parkinson’s disease is confirmed, actively cooperate with the doctor’s treatment and take medication as instructed to effectively control symptoms, delay disease progression and effectively prevent the switching phenomenon.  Switching phenomenon refers to the phenomenon of fluctuation of drug efficacy after long-term application of levodopa-like drugs in patients with Parkinson’s disease, which is a kind of side effect produced by this kind of drugs. The main manifestation of “off” is the sudden appearance of limb stiffness and inability to move, just like a power failure, for example, when walking, suddenly unable to take a step, as if wearing shackles on the feet and lead hammer, struggling to take a step. At the time of “opening”, although no treatment was added, the activity suddenly became normal, the stiffness of the limbs disappeared, and the limbs could move freely.  This is a relatively common and difficult complication in the late stage of treatment with levodopa-based drugs, and the mechanism of control is not well understood. It is possible that the receptor response to changes in dopamine levels produces sharp fluctuations (hypersensitivity state). Therefore, patients are reminded to take their medications as instructed, because in clinical treatment, some patients do adjust their medications without authorization, add or subtract medications, add or subtract doses, take medications irregularly, and some patients even take only medications of methyldopa for a long time and take a lot of them, which results in easy to cause switching phenomena and motor complications such as isokinetic disorders.  If it is found that the switching phenomenon has already appeared and the effect of medication regulation is still not good, the surgical treatment of brain pacemaker can be considered, and the postoperative opening and regulation can effectively control the involuntary movement disorder of the limbs. After surgery, it can also prolong the “on” period and shorten the “off” period, moderate the dramatic fluctuations of “on-off”, eliminate involuntary movements and “end-of-dose” deterioration effects, and improve the quality of life of patients.