Acute relief of "off" symptoms


Which medication treats "off" symptoms faster:

1) an oral 100 mg dose of levodopa, together with carbidopa or benzseride


2) an equivalent oral dose of a dopamine agonist, like pramipexole (1 mg) or ropinirole (5 mg)  ?

My neurologists all said levodopa works faster, but none could cite a research study to that effect, nor could I find one on PubMed.

I have read that the speed of levodopa onset may become slowed in advanced Parkinson's, due to less enzyme available to convert it to dopamine in the brain.  The dopamine agonists do not require enzymatic conversion to work.

Personally, I take one of each (levodopa AND a dopamine agonist) to break a bad "off" episode.






Dispersible Madopar works in less than 10 minutes and is the usual " rescue" prescription.

Certainly works for my husband and has saved us in many an awkward situation!