[Wearing-off phenomenon--neurological approach].

The mechanism of the wearing-off phenomenon and the method of how to control it by means of anti-parkinsonian medications is described. To control the wearing-off phenomenon, it is useful to administer L-dopa before eating because absorption of L-dopa is less when competing with amino acids. Administration of L-dopa four or five times a day is also useful. Dopamin agonists(e.g., bromocriptine, pergolide, talipexole, and cabergoline), and monoamine oxidase inhibitors(e.g., selegiline) control the wearing-off phenomenon, and may also suppress its occurrence. As a specific method for controlling the wearing-off phenomenon, continuous administration of anti-parkinsonian drugs by the intra-alimentary tract or a subcutaneous injection is useful. It is important to avoid early wearing-off phenomenon when treating patients with Parkinson's disease.