scholarly journals Parkinson's Disease - Levodopa Complications

1999 ◽  
Vol 26 (S2) ◽  
pp. S13-S20 ◽  
Author(s):  
David B. King
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Management Strategies ◽  
Clinical Syndrome ◽  
Motor Fluctuations ◽  
Current Management ◽  
Resting Tremor ◽  
Wearing Off ◽  
Psychiatric Complications

Parkinson's disease is a readily recognized clinical syndrome, characterized by resting tremor, rigidity, bradykinesia and loss of postural reflexes. The introduction of levodopa transformed our management of this disease. As our experience has increased the long term side effects of levodopa have become more apparent. Levodopa complications comprise: wearing off, motor fluctuations, and psychiatric complications. The complexity of these clinical phenomena has been worked out with time and is now well-recognized. A number of management strategies can ameliorate these long-term complications. This article reviews the current management of late-stage Parkinson's disease.

Long-term detection of motor fluctuations by wrist-worn sensors in Parkinson's disease

Basal Ganglia ◽  
2017 ◽  
Vol 8 ◽  
pp. 22
Author(s):  
Daniel Pichler ◽  
Urban Fietzek ◽  
Franz Pfister ◽  
Ahmad Ahmadi ◽  
Felix Achilles ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Fluctuations

scholarly journals A Spanish Consensus on the Use of Safinamide for Parkinson’s Disease in Clinical Practice

2020 ◽  
Vol 10 (3) ◽  
pp. 176 ◽  
Author(s):  
Javier Pagonabarraga ◽  
José Matías Arbelo ◽  
Francisco Grandas ◽  
Maria-Rosario Luquin ◽  
Pablo Martínez Martín ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Practice ◽  
Motor Fluctuations ◽  
Adjunctive Treatment ◽  
Good Tolerability ◽  
Time Control ◽  
Clinical Scenarios ◽  
Off Time

Safinamide is an approved drug for the treatment of motor fluctuations in Parkinson’s disease (PD). Scarce data are available on its use in clinical practice. A group of Spanish movement disorders specialists was convened to review the use of safinamide across different clinical scenarios that may guide neurologists in clinical practice. Eight specialists with recognized expertise in PD management elaborated the statements based on available evidence in the literature and on their clinical experience. The RAND/UCLA method was carried, with final conclusions accepted after a 2-round modified Delphi process. Higher level of agreement between panellists was reached for the following statements. Safinamide significantly improves mean daily OFF time without troublesome dyskinesias. Adjunctive treatment with safinamide is associated with motor improvements in patients with mid-to-late PD. The efficacy of safinamide on motor fluctuations is maintained at long-term, with no increase over time in dyskinesias severity. The clinical benefits of safinamide on pain and depression remain unclear. Safinamide presents a similar incidence of adverse events compared with placebo. The efficacy and safety of safinamide shown in the pivotal clinical trials are reproduced in clinical practice, with improvement of parkinsonian symptoms, decrease of daily OFF time, control of dyskinesias at the long term, and good tolerability and safety.

Pharmacokinetics of levodopa and personalized therapy in Parkinson’s disease

2020 ◽  
Vol 18 (5) ◽  
pp. 36-41
Author(s):  
A. A. TAPPAKHOV ◽  
◽  
T. E. POPOVA ◽  
T. G. GOVOROVA ◽  
Yu. I. KHABAROVA ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Biological Activity ◽  
Personalized Therapy ◽  
Motor Fluctuations ◽  
Dopa Decarboxylase ◽  
Type B ◽  
Prevention And Treatment

The article provides a review of the pharmacokinetics of levodopa and personalized therapy for Parkinson’s disease. We analyzed the methods used to prolong the action of levodopa using peripheral inhibitors of DOPA decarboxylase, catechol-O-methyltransferase inhibitors, and monoamine oxidase type B inhibitors. The influence of levodopa metabolites with their own biological activity in the possible progression of the disease is emphasized. The role of determining the concentration of levodopa in blood plasma is discussed, as well as the concept of «continuous dopamine stimulation» for the prevention and treatment of side effects of long-term levodopa therapy, such as drug dyskinesias, motor and non-motor fluctuations. The article also provides an overview of the modern forms of levodopa that are currently being investigated.

scholarly journals Current Status of Levodopa Therapy in Idiopathic Parkinson's Disease

1987 ◽  
Vol 14 (S3) ◽  
pp. 452-454 ◽  
Author(s):  
S. Gauthier ◽  
L. Gauthier
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dopamine Agonists ◽  
Inverse Correlation ◽  
Current Status ◽  
Average Delay ◽  
Younger Patients ◽  
Future Studies ◽  
Resting Tremor ◽  
Wearing Off

ABSTRACT:Levodopa is currently used at all stages of Parkinson's disease, particularly from Stage 3 onward. Most patients start levodopa within four years of the onset of disease, earlier in the akineto-rigid patients (average delay of 2.1 years) than in those where resting tremor predominates (average delay of 3.4 years). Advanced age (>80) is no deterrent to the use of levodopa if required. Wearing off is most noticeable in Stage 3 or after 10 years of therapy with levodopa. An inverse correlation was found between age and wearing off, suggesting a marked sensitivity of younger patients to levodopa. Future studies on the use of dopamine agonists should thus be stratified according to age.

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