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Table 2 Recommendation for the management of peak-dose dyskinesia

From: The recommendations of Chinese Parkinson’s disease and movement disorder society consensus on therapeutic management of Parkinson’s disease

Reduce the single dose of levodopa/benseraside or levodopa/carbidopa per time; or appropriately add dopamine agonists or COMT inhibitors if the motor symptoms deteriorate after the dose of levodopa is reduced.
Add amantadine (Level C evidence) [44].
Add atypical neuroleptics, such as clozapine, but start with an initial low dosage and then increase gradually, and closely monitor granulocytes.
Replace controlled-release levodopa with immediate-release levodopa to avoid the cumulative effects of controlled-release levodopa, which can aggravate dyskinesia.