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Levodopa: past, present, and future.
Eur Neurol. 2009; 62(1):1-8.EN

Abstract

Levodopa has been the mainstay of treatment for Parkinson's disease (PD) for more than 40 years. During this time, researchers have strived to optimize levodopa formulations to minimize side effects, enhance central nervous system (CNS) bioavailability, and achieve stable therapeutic plasma levels. Current strategies include concomitant treatment with inhibitors of dopa decarboxylase (DDC) and catechol-O-methyltransferase (COMT) to prolong the peripheral levodopa half-life and increase CNS bioavailability. Levodopa combined with DDC inhibition is the current standard method of delivering levodopa for symptomatic treatment of PD. Recent research suggests that continuous dopaminergic stimulation that more closely approximates physiological stimulation may delay or prevent the development of motor fluctuations ('wearing off') and dyskinesias. Strategies currently being used to achieve more continuous dopaminergic stimulation include the combination of an oral levodopa/DDC inhibitor with a COMT inhibitor and the enteral infusion of a levodopa gel formulation. Attempts are underway to develop oral and transdermal very long-acting levodopa preparations.

Authors+Show Affiliations

Departments of Neurology, Molecular Pharmacology, and Physiology, University of South Florida, Tampa, FL 33606, USA. rhauser@health.usf.edu

Pub Type(s)

Historical Article
Journal Article
Review

Language

eng

PubMed ID

19407449

Citation

Hauser, Robert A.. "Levodopa: Past, Present, and Future." European Neurology, vol. 62, no. 1, 2009, pp. 1-8.
Hauser RA. Levodopa: past, present, and future. Eur Neurol. 2009;62(1):1-8.
Hauser, R. A. (2009). Levodopa: past, present, and future. European Neurology, 62(1), 1-8. https://doi.org/10.1159/000215875
Hauser RA. Levodopa: Past, Present, and Future. Eur Neurol. 2009;62(1):1-8. PubMed PMID: 19407449.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Levodopa: past, present, and future. A1 - Hauser,Robert A, Y1 - 2008/09/09/ PY - 2009/02/02/accepted PY - 2009/5/2/entrez PY - 2009/5/2/pubmed PY - 2009/8/20/medline SP - 1 EP - 8 JF - European neurology JO - Eur Neurol VL - 62 IS - 1 N2 - Levodopa has been the mainstay of treatment for Parkinson's disease (PD) for more than 40 years. During this time, researchers have strived to optimize levodopa formulations to minimize side effects, enhance central nervous system (CNS) bioavailability, and achieve stable therapeutic plasma levels. Current strategies include concomitant treatment with inhibitors of dopa decarboxylase (DDC) and catechol-O-methyltransferase (COMT) to prolong the peripheral levodopa half-life and increase CNS bioavailability. Levodopa combined with DDC inhibition is the current standard method of delivering levodopa for symptomatic treatment of PD. Recent research suggests that continuous dopaminergic stimulation that more closely approximates physiological stimulation may delay or prevent the development of motor fluctuations ('wearing off') and dyskinesias. Strategies currently being used to achieve more continuous dopaminergic stimulation include the combination of an oral levodopa/DDC inhibitor with a COMT inhibitor and the enteral infusion of a levodopa gel formulation. Attempts are underway to develop oral and transdermal very long-acting levodopa preparations. SN - 1421-9913 UR - https://www.unboundmedicine.com/medline/citation/19407449/Levodopa:_past_present_and_future_ L2 - https://www.karger.com?DOI=10.1159/000215875 DB - PRIME DP - Unbound Medicine ER -