These movements may be mild or severe, and either very rapid or very slow. The only effective way to control these drug-induced movements is to lower the dose of levodopa or to use drugs that block dopamine. However, these remedies usually cause disease symptoms to reappear. Doctors and patients must work together closely to find a tolerable balance between the drug's benefits and side effects. Other more troubling and distressing problems may occur with long-term levodopa use.
Symptoms gradually begin to return.
The period of effectiveness from each dose may get shorter, called the wearing-off effect. These effects probably indicate that the patient's response to the drug is changing or that the disease is progressing. One approach to alleviating these side effects is to take levodopa more often and in smaller amounts. Sometimes, physicians instruct patients to stop levodopa for several days in an effort to improve the response to the drug and to manage the complications of long-term levodopa therapy. Because serious complications are possible, drug holidays should be attempted only under a physician's direct supervision, preferably in a hospital.