Objective: To survey Parkinson’s disease (PD) patients regarding their willingness and experience in withdrawal of their dopaminergic medications.

Background: Parkinson’s disease patients are asked to withhold dopamine medications for certain periods of time for clinical reasons, as well as for research studies that require a medication withdrawal as part of its protocol. However, there is very little literature on patient perceptions of these medication withdrawals, and the willingness to agree with medication discontinuation varies. Therefore, it is important to assess patients’ overall experience and perceptions of this short-term medication withdrawal.

Methods: Patients with idiopathic PD were asked to participate in a survey assessing dopamine withdrawal. Two groups of patients were identified, those who had previously withheld dopamine therapy for a period of time between 24 and 96 hours, and those who had never purposely stopped dopamine therapy. Self-reported severity of off-symptoms, adverse events, and willingness to participate in a medication withdrawal were presented in survey form. All items were rated on a Likert scale ranging between 1-5. Willingness was defined as 1=not at all willing, 3=moderately willing, 5=very willing. Group differences were tested using Wilcoxon rank sum. Correlations were tested using Spearman’s correlation.

Results: A total of 122 patients completed the survey (57.4% males, mean age 66.4 years): 88 had never stopped dopamine medications, while 34 had experienced medication withdrawal. Of the patients who had gone off their medications, none had experienced a serious adverse event due to the withdrawal. The most common motor symptom during withdrawal was tremor, and the most common non-motor symptom was sleep disturbance. Across all patients, the willingness to complete a medication withdrawal study averaged 3.4. There was no significant difference in willingness between males and females. Patients with a longer disease duration were significantly less willing to go off their medications (p<.001).

Conclusions: The results suggest that withdrawing from dopamine-replacement therapy for PD for a short period of time is a safe procedure. Furthermore, patients with PD are moderately willing to go off their medications. These results can provide insight for future researchers who hope to conduct studies that require a withdrawal of PD medications.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/patient-perceptions-of-dopaminergic-therapy-withdrawal-in-parkinsons-disease/