Tags

Type your tag names separated by a space and hit enter

The pharmacological therapeutic management of levodopa-induced dyskinesias in patients with Parkinson's disease.
J Neurol. 2000 Apr; 247 Suppl 2:II51-7.JN

Abstract

The clinical management of levodopa-induced dyskinesia is difficult. Once present, dyskinesias are only partially improved by lowering the daily dose of levodopa and co-administering a D2 dopamine agonist. Therefore it appears to be necessary to use an NMDA-antagonist, such as amantadine, as an antidyskinetic agent. Clozapine may also improve dyskinesia without worsening akinesia, but it requires strict haematological monitoring. A long-term continuous subcutaneous infusion of apomorphine significantly reduces the dose of levodopa required, thereby markedly reducing dyskinesia, but this is difficult from a practical point of view. If none of these pharmacological strategies is successful, surgery should then be considered. Since the management of established levodopa-induced dyskinesia is difficult and often disappointing, efforts should be encouraged to try to prevent the occurrence of dyskinesia, before levodopa priming. This seems to be best achieved by the use of D2 dopamine agonists in the early stages of the disease, before, or in combination with, levodopa.

Authors+Show Affiliations

Laboratoire de Pharmacologie Mèdicale et Clinique, Faculté de Médicine, Toulouse, France. rascol@cict.fr

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

10991666

Citation

Rascol, O. "The Pharmacological Therapeutic Management of Levodopa-induced Dyskinesias in Patients With Parkinson's Disease." Journal of Neurology, vol. 247 Suppl 2, 2000, pp. II51-7.
Rascol O. The pharmacological therapeutic management of levodopa-induced dyskinesias in patients with Parkinson's disease. J Neurol. 2000;247 Suppl 2:II51-7.
Rascol, O. (2000). The pharmacological therapeutic management of levodopa-induced dyskinesias in patients with Parkinson's disease. Journal of Neurology, 247 Suppl 2, II51-7.
Rascol O. The Pharmacological Therapeutic Management of Levodopa-induced Dyskinesias in Patients With Parkinson's Disease. J Neurol. 2000;247 Suppl 2:II51-7. PubMed PMID: 10991666.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The pharmacological therapeutic management of levodopa-induced dyskinesias in patients with Parkinson's disease. A1 - Rascol,O, PY - 2000/9/19/pubmed PY - 2000/9/19/medline PY - 2000/9/19/entrez SP - II51 EP - 7 JF - Journal of neurology JO - J Neurol VL - 247 Suppl 2 N2 - The clinical management of levodopa-induced dyskinesia is difficult. Once present, dyskinesias are only partially improved by lowering the daily dose of levodopa and co-administering a D2 dopamine agonist. Therefore it appears to be necessary to use an NMDA-antagonist, such as amantadine, as an antidyskinetic agent. Clozapine may also improve dyskinesia without worsening akinesia, but it requires strict haematological monitoring. A long-term continuous subcutaneous infusion of apomorphine significantly reduces the dose of levodopa required, thereby markedly reducing dyskinesia, but this is difficult from a practical point of view. If none of these pharmacological strategies is successful, surgery should then be considered. Since the management of established levodopa-induced dyskinesia is difficult and often disappointing, efforts should be encouraged to try to prevent the occurrence of dyskinesia, before levodopa priming. This seems to be best achieved by the use of D2 dopamine agonists in the early stages of the disease, before, or in combination with, levodopa. SN - 0340-5354 UR - https://www.unboundmedicine.com/medline/citation/10991666/The_pharmacological_therapeutic_management_of_levodopa_induced_dyskinesias_in_patients_with_Parkinson's_disease_ L2 - https://dx.doi.org/10.1007/pl00007761 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.