Levodopa-induced dyskinesia in Parkinson’s disease: clinical features, pathogenesis, prevention and treatment
Levodopa is the most effective drug for treating Parkinson’s disease. However, long-term use of levodopa is often complicated by significantly disabling fluctuations and dyskinesias negating its beneficial effects. Younger age of Parkinson’s disease onset, disease severity, and high levodopa dose in...
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Published in | Postgraduate Medical Journal Vol. 83; no. 980; pp. 384 - 388 |
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Main Authors | , , |
Format | Journal Article Book Review |
Language | English |
Published |
London
The Fellowship of Postgraduate Medicine
01.06.2007
BMJ Oxford University Press BMJ Group |
Subjects | |
Online Access | Get full text |
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Summary: | Levodopa is the most effective drug for treating Parkinson’s disease. However, long-term use of levodopa is often complicated by significantly disabling fluctuations and dyskinesias negating its beneficial effects. Younger age of Parkinson’s disease onset, disease severity, and high levodopa dose increase the risk of development of levodopa-induced dyskinesias (LID). The underlying mechanisms for LID are unclear though recent studies indicate the importance of pulsatile stimulation of striatal postsynaptic receptors in their pathogenesis. The non-human primates with MPTP-induced parkinsonism serve as a useful model to study dyskinesia. Once established, LID are difficult to treat and therefore efforts should be made to prevent them. The therapeutic and preventative strategies for LID include using a lower dosage of levodopa, employing dopamine agonists as initial therapy in Parkinson’s disease, amantadine, atypical neuroleptics, and neurosurgery. LID can adversely affect the quality of life and increase the cost of healthcare. |
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Bibliography: | Correspondence to:
Dr Bhomraj Thanvi
Department of Integrated Medicine, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Gwendolen Road, Leicester LE5 4PW, UK; bhanvi@hotmail.com ark:/67375/NVC-SWBF7WDD-T istex:2D15236066AEAFF36F68FA39468D8030A84D5CAC href:postgradmedj-83-384.pdf local:0830384 PMID:17551069 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0032-5473 1469-0756 |
DOI: | 10.1136/pgmj.2006.054759 |