Michael S. Okun, MD

As Parkinson's disease progresses, dopamine and dopamine agonists that control tremor and stiffness can wear off too early or cause dyskinesia when they peak in the bloodstream.  

In this ReCAP, Dr Michael Okun, professor and chair of neurology at the University of Florida, explains that adjustments to dose, timing, or delivery mode of these medications can smooth out some fluctuations. He reports that catechol-O-methyltransferase inhibitors, such as opicapone, tolcapone, and entacapone, can extend the effect of dopamine and the addition of amantadine or istradefylline can suppress dyskinesia. 

He points out that for other patients, surgical options, such as deep brain stimulation or focused ultrasound, can alter how the brain controls disordered movement or implanted pumps can better regulate the delivery of medication either subcutaneously or directly into the gut. 

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Michael S. Okun, MD, Chair of Neurology, College of Medicine; Director Norman Fixel Institute, University of Florida, Gainesville, Florida 

Michael S. Okun, MD, has disclosed no relevant financial relationships

As Parkinson's disease progresses, dopamine and dopamine agonists that control tremor and stiffness can wear off too early or cause dyskinesia when they peak in the bloodstream.  

In this ReCAP, Dr Michael Okun, professor and chair of neurology at the University of Florida, explains that adjustments to dose, timing, or delivery mode of these medications can smooth out some fluctuations. He reports that catechol-O-methyltransferase inhibitors, such as opicapone, tolcapone, and entacapone, can extend the effect of dopamine and the addition of amantadine or istradefylline can suppress dyskinesia. 

He points out that for other patients, surgical options, such as deep brain stimulation or focused ultrasound, can alter how the brain controls disordered movement or implanted pumps can better regulate the delivery of medication either subcutaneously or directly into the gut. 

--

Michael S. Okun, MD, Chair of Neurology, College of Medicine; Director Norman Fixel Institute, University of Florida, Gainesville, Florida 

Michael S. Okun, MD, has disclosed no relevant financial relationships

As Parkinson's disease progresses, dopamine and dopamine agonists that control tremor and stiffness can wear off too early or cause dyskinesia when they peak in the bloodstream.  

In this ReCAP, Dr Michael Okun, professor and chair of neurology at the University of Florida, explains that adjustments to dose, timing, or delivery mode of these medications can smooth out some fluctuations. He reports that catechol-O-methyltransferase inhibitors, such as opicapone, tolcapone, and entacapone, can extend the effect of dopamine and the addition of amantadine or istradefylline can suppress dyskinesia. 

He points out that for other patients, surgical options, such as deep brain stimulation or focused ultrasound, can alter how the brain controls disordered movement or implanted pumps can better regulate the delivery of medication either subcutaneously or directly into the gut. 

--

Michael S. Okun, MD, Chair of Neurology, College of Medicine; Director Norman Fixel Institute, University of Florida, Gainesville, Florida 

Michael S. Okun, MD, has disclosed no relevant financial relationships