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Original Article
- Less Pulsatile Levodopa Therapy (6 Doses Daily) Is Associated with a Reduced Incidence of Dyskinesia
- Mark M. Lin, Robert Laureno
- J Mov Disord. 2019;12(1):37-42. Published online January 30, 2019
- DOI: https://doi.org/10.14802/jmd.18046
- 10,623 View
- 299 Download
- 10 Web of Science
- 9 Crossref
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Abstract
PDF - Objective
To evaluate whether less pulsatile levodopa therapy (LPT) can reduce the development of levodopa-induced dyskinesia (LID).
Methods
This is a retrospective cohort study of patients with Parkinson’s disease at the movement disorders clinic of Medstar Washington Hospital Center. The study was not blinded or randomized. Patients were seen between August 2002 and August 2018. During these years, we treated patients with less pulsatile (6 doses daily) levodopa treatment to reduce LID. Occurrence of LID was recorded.
Results
Ninety-five patients with Parkinson’s disease taking levodopa were divided into two groups: 1) patients who were initially managed on LPT or who switched from traditional therapy (TT) (n = 61) (mean disease duration: 7.7 ± 4.8 years, mean levodopa duration: 5.6 ± 4.5 years and mean observation time: 4.3 ± 3.4 years), and 2) patients on TT throughout the observation period or until they developed dyskinesia (n = 34) (mean disease duration: 8.3 ± 3.8 years, mean levodopa duration: 6.2 ± 4.2 years and mean observation time: 4.1 ± 3.4 years). Three of the 61 LPT patients developed dyskinesia during the observation period. One of the patients developed dyskinesia after being switched to pulsatile doses by another doctor. In the other two, dyskinesia was minimal. In contrast to this 4.9% cumulative incidence, dyskinesia occurred in 50% (17/34) of TT patients, an incidence similar to that in published data (p < 0.001).
Conclusion
Less pulsatile levodopa with 6 daily doses was associated with a low incidence of LID. Further study of this method of treatment is warranted. -
Citations
Citations to this article as recorded by
- Reduced Plasma Levodopa Fluctuations with More Frequent Administration of a Novel Carbidopa/Levodopa Functionally Scored Tablet
Thomas N. Chase, Ahmad AL‐Sabbagh, Minako Koga, Kathleen Clarence‐Smith
Clinical Pharmacology in Drug Development.2024; 13(4): 380. CrossRef - Effects of Intracerebral Aminophylline Dosing on Catalepsy and Gait in an Animal Model of Parkinson’s Disease
Érica de Moraes Santos Corrêa, Gustavo Christofoletti, Albert Schiaveto de Souza
International Journal of Molecular Sciences.2024; 25(10): 5191. CrossRef - Dopamine D1 Agonists: First Potential Treatment for Late-Stage Parkinson’s Disease
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Biomolecules.2023; 13(5): 829. CrossRef - Classification of l-DOPA pharmacokinetics shapes and creating a predictive model
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Parkinsonism & Related Disorders.2023; 114: 105798. CrossRef - Personalized Medicine Approach in Treating Parkinson’s Disease, Using Oral Administration of Levodopa/Carbidopa Microtablets in Clinical Practice
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Journal of Personalized Medicine.2021; 11(8): 720. CrossRef - Current Knowledge on the Background, Pathophysiology and Treatment of Levodopa-Induced Dyskinesia—Literature Review
Michał Hutny, Jagoda Hofman, Aleksandra Klimkowicz-Mrowiec, Agnieszka Gorzkowska
Journal of Clinical Medicine.2021; 10(19): 4377. CrossRef - Pallidal versus subthalamic nucleus deep brain stimulation for levodopa‐induced dyskinesia
Shi‐Ying Fan, Kai‐Liang Wang, Wei Hu, Robert S. Eisinger, Alexander Han, Chun‐Lei Han, Qiao Wang, Shimabukuro Michitomo, Jian‐Guo Zhang, Feng Wang, Adolfo Ramirez‐Zamora, Fan‐Gang Meng
Annals of Clinical and Translational Neurology.2020; 7(1): 59. CrossRef - A Stage-Based Approach to Therapy in Parkinson’s Disease
Claudia Carrarini, Mirella Russo, Fedele Dono, Martina Di Pietro, Marianna G. Rispoli, Vincenzo Di Stefano, Laura Ferri, Filomena Barbone, Michela Vitale, Astrid Thomas, Stefano Luca Sensi, Marco Onofrj, Laura Bonanni
Biomolecules.2019; 9(8): 388. CrossRef - The Gut Microbiome: A Therapeutically Targetable Site of Peripheral Levodopa Metabolism
Eoin Mulroy, Kailash P. Bhatia
Movement Disorders Clinical Practice.2019; 6(7): 547. CrossRef
- Reduced Plasma Levodopa Fluctuations with More Frequent Administration of a Novel Carbidopa/Levodopa Functionally Scored Tablet
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