We use Apokyn as needed for off times. Our PD meds include Rytary, Sinemet, and Amantadine @ 4 hour intervals (5am-9pm). Apokyn is applied into the stomach with a needle and we consider it a quick start. At this time, it is very helpful but does increase dyskinesia (dancing motion) some times. Dyskinesia increases the risk of falls. We continue to work with the neurologist to balance the meds which is important.