Videos

2 experts are featured in this series.

Panelists discuss how a 54-year-old woman with early-onset Parkinson disease presenting with troublesome peak-dose dyskinesia affecting her work performance illustrates the challenge of managing patients who have both dyskinesia and likely OFF episodes, requiring careful assessment of functional impacts through targeted questioning about daily activities, work performance, and social interactions, since patients often minimize or remain unaware of their dyskinesia's true impact while caregivers may provide crucial insights into how the involuntary movements affect not only the patient but also family dynamics and professional relationships.

2 experts are featured in this series.

Panelists discuss how dyskinesia affects 30% to 50% of Parkinson patients by 5 years and over 90% by 10 years, creating significant functional limitations including impaired writing, eating, and dressing abilities, increased fall risk, job performance challenges, social isolation due to embarrassment about abnormal movements, and restrictions on therapeutic options since increasing levodopa doses to manage OFF time would worsen dyskinesia, ultimately impacting both patients' basic human dignity and their caregivers' quality of life.

A panelist discusses the use of dual orexin receptor antagonists as a first-line treatment for chronic insomnia due to their efficacy in improving sleep without the risks of dependence or cognitive issues, while also noting their effectiveness in patients with psychophysiologic insomnia and the importance of managing patient expectations regarding their use.

2 experts are featured in this series.

Panelists discuss how newer Parkinson disease therapies may impact dyskinesia management by potentially providing continuous dopaminergic stimulation that could prevent dyskinesia development if used early, though current evidence from phase 3 trials shows mixed results with improvements in good ON time (ON time without troublesome dyskinesia) but limited reduction in existing troublesome dyskinesia, suggesting that while these treatments offer promise, more research is needed to determine their effectiveness in reducing dyskinesia in patients who already experience it.

2 experts are featured in this series.

Panelists discuss how recent advancements in Parkinson disease treatment include 3 newly approved medications—an oral extended-release carbidopa-levodopa with mucoadhesive properties, a subcutaneous foslevodopa infusion, and a subcutaneous apomorphine infusion—that aim to provide more continuous dopamine stimulation and reduce motor fluctuations by offering longer-lasting benefits and smoother symptom control compared with traditional immediate-release formulations.

A panelist discusses the strong efficacy and tolerability of dual orexin receptor antagonists (DORAs) for insomnia, noting their minimal adverse effects compared with older medications like benzodiazepines. DORAs are now seen as a first-line treatment option due to their favorable balance of safety and effectiveness, although insurance coverage can influence their availability.