A 72-year-old man with Parkinson's disease diagnosed 3 years ago presents with worsening motor fluctuations on Levodopa/Carbidopa 100/25 mg three time...

Question

A 72-year-old man with Parkinson's disease diagnosed 3 years ago presents with worsening motor fluctuations on Levodopa/Carbidopa 100/25 mg three times daily. He experiences end-of-dose wearing off approximately 30 minutes before his next dose. His cognition is preserved (MoCA 27/30). What is the MOST appropriate adjustment to his medication?

Accepted Answer

Add Entacapone to each dose of Levodopa/Carbidopa

Answer

Increase the dose of each Levodopa/Carbidopa tablet to 200/50 mg TDS

Answer

Switch Levodopa/Carbidopa to a dopamine agonist

Answer

Add Haloperidol for any associated dyskinesia

Answer

Reduce the frequency of Levodopa dosing to twice daily

uk-dgm MCQ (SBA): End-of-Dose Wearing Off in Parkinson's Disease