Counsel patients starting selegiline about the tyramine restriction and amphetamine metabolites, and screen proactively for impulse control disorder when any dopaminergic agent is added or escalated. Recognize morning foot dystonia as an off-period phenomenon rather than a structural problem so it is treated with dopaminergic optimization rather than orthopedic or surgical intervention.

Entacapone is taken with each levodopa dose because it acts briefly; They can cause a classic array of symptoms: dry mouth, dry eyes, blurred vision, urinary retention, along with confusion, hallucinations, and frank psychosis; We turn to them primarily to address resting tremors or dystonia that haven't responded well to levodopa; Strictly peripheral COMT inhibitor; Trihexyphenidyl and benztropine are the main choices