Dyskinesia—what you need to know

First, let’s define what dyskinesia is

Dyskinesias are involuntary, erratic, writhing movements of the face, arms, legs, or trunk. They are often fluid and dance-like, but they may also cause rapid jerking or slow and extended muscle spasms.

It’s different from OFF time. OFF time is when your PD medication, like levodopa, wears off throughout the day and tremors, slowness, and other Parkinson's disease symptoms return. They may include shakiness and jitters, slowed movement, and difficulty trying to stand.

It can be easy to mistake dyskinesia for other Parkinson's disease symptoms—such as tremors. What you may not know is that dyskinesia is a complication of long-term levodopa use to treat Parkinson's disease.

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Meet Dave from Berkeley, CA

This is one patient's experience with dyskinesia.

Visit again for new stories from real Patients, Care Partners, and HCPs who share their experiences with dyskinesia.

Dyskinesia may:

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Get worse when you're stressed or feeling excited

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Accelerate your heart rate, breathing, and even your thinking

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Happen more frequently as Parkinson's disease progresses

What causes dyskinesia?

To best understand dyskinesia, you first have to know about dopamine.

Dopamine is a chemical that sends signals between the nerve cells of your brain. These signals help make voluntary movement happen.

As a person with Parkinson's disease, your brain produces less dopamine over time. This affects how you move and is why you experience tremors, slowness, and other Parkinson's disease symptoms.

To treat Parkinson's disease, many doctors use a medication called levodopa, which helps replenish the lack of dopamine in the brain. Increasing dopamine can help ease many of Parkinson's symptoms. This is called GOOD ON time, also known as ON time without troublesome dyskinesia.

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GOOD On time

This occurs when PD medication is working as expected. PD symptoms are well-controlled and people with Parkinson's are not experiencing dyskinesia

Levodopa works well in treating Parkinson’s disease—often for several years. As Parkinson’s disease progresses, levodopa can wear off sooner between doses. At these times, symptoms worsen. This is called OFF time.

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OFF time

When your medication, like levodopa, wears off throughout the day and tremors, slowness, and other Parkinson's disease symptoms return. They may include shakiness and jitters, slowed movement, and difficulty trying to stand

When first initiated on levodopa therapy, Parkinson's disease symptoms are well-controlled, and these benefits can last for several hours. This is when you experience GOOD ON time.

As dopamine-producing brain cells deplete over time, the ability to store dopamine diminishes and the effects of levodopa do not last as long. This is the point where you will experience OFF time (tremors, bradykinesia, etc.) resulting in the need to take more doses of levodopa throughout the day.

Eventually after a few years of treatment, the clinical response to levodopa changes and dyskinesias and motor fluctuations will become more prominent. When levodopa is too low, OFF symptoms may be seen and when levodopa is too high, dyskinesias may be seen.

Dyskinesia is common and can impact daily living for people living with Parkinson's disease

Studies showed 73% of people with Parkinson's said dyskinesia had a functional impact on them

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Dyskinesia can also have a social and emotional impact

The same studies showed 72% of PWP said dyskinesia had a social impact on them

In a 2012 survey, 40 respondents identified their main concerns:

  • Embarrassment
  • Avoiding family events and gatherings
  • Family tension

GOCOVRI® is designed to help! It's amantadine—but in a different formulation and specifically indicated to treat your dyskinesia or OFF episodes

GOCOVRI® is different because you take it at night. GOCOVRI® releases slowly in your body, so that you reach high levels by the morning, before your first levodopa dose. Then, GOCOVRI® slowly releases to stay with you all day.

In studies, people who took GOCOVRI® noticed a reduction in dyskinesia and OFF time and spent more of their day having GOOD ON time.

Learn more about GOCOVRI®
Ask your doctor about GOCOVRI®
what is gocovri?

GOCOVRI® (amantadine) extended release capsules is a prescription medicine used:

  • for the treatment of dyskinesia (sudden uncontrolled movements) in people with Parkinson’s disease who are treated with levodopa therapy or levodopa therapy with other medicines that increase the effects of dopamine in the brain.
  • with levodopa and carbidopa in people with Parkinson’s disease who are having “off” episodes.

It is not known if GOCOVRI is safe and effective in children.

important safety information

DO NOT take GOCOVRI if you have severe kidney problems.

what should i avoid while taking gocovri?

Do not stop or change the dose of GOCOVRI before talking with your doctor. Call your healthcare provider if you have symptoms of withdrawal such as fever, confusion, or severe muscle stiffness.
Do not drink alcohol while taking GOCOVRI as it can increase your chances of serious side effects.
Do not drive, operate machinery, or do other dangerous activities until you know how GOCOVRI affects you.
If you took too much GOCOVRI, call your doctor or go to the nearest hospital emergency room right away.

what are the possible side effects of gocovri?
  • Falling asleep during normal activities. Activities may include driving, talking, or eating. You may fall asleep without being drowsy or warning.
  • Suicidal thoughts or actions and depression. Tell your doctor if you have new or sudden changes in mood, behaviors, thoughts, or feelings, including thoughts about hurting yourself or ending your life.
  • Hallucinations. GOCOVRI can cause or worsen hallucinations (seeing or hearing things that are not real) or psychotic behavior.
  • Feeling dizzy, faint or lightheaded, especially when you stand up (orthostatic hypotension). Lightheadedness or fainting may happen when getting up too quickly after long periods of time, when first starting GOCOVRI, or if your dose has been increased.
  • Unusual urges. Examples include gambling, sexual urges, spending money, binge eating, and the inability to control them.

The most common side effects of GOCOVRI include dry mouth, swelling of legs and feet, constipation, and falls. If you or your family notices that you are developing any new, unusual or sudden changes in behavior or related symptoms, tell your healthcare provider right away.

These are not all the possible side effects of GOCOVRI. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all medical conditions, including if you:
  • have kidney problems.
  • have unexpected or unpredictable sleepiness, sleep disorders, or currently take medication to help you sleep or make you drowsy.
  • are pregnant or plan to become pregnant or are breastfeeding or plan to breastfeed. GOCOVRI may harm your unborn baby and can pass into your breastmilk.

Tell your doctor about all the medicines you take. Include prescription and over-the-counter medicines, vitamins, and herbal supplements.

Especially tell your doctor if you take medicines like sodium bicarbonate, or have had or are planning to have a live flu vaccination (nasal spray). You can receive the flu vaccination shot but should not get a live flu vaccine while taking GOCOVRI.

Please see full Patient Prescribing Information.