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An analysis of treatment options and outcome in patients with Parkinson's disease and severe dyskinesias.
Ann Clin Lab Sci. 1994 Jan-Feb; 24(1):12-21.AC

Abstract

Forty-one patients with Parkinson's disease and severe dyskinesias were analyzed retrospectively to determine if some general principles would emerge to aid physicians handling this complication of treatment. Dyskinesia type (high dopa chorea [HDC], low dopa chorea [LDC], high dopa dystonia [HDD], and low dopa dystonia [LDD]) predicted response to treatment and whether or not levodopa dose reduction would benefit dyskinesias without producing unacceptable "offs." High dopa chorea improved best but at the expense of increased "off" time, followed by LDD, HDD, and LDC. Levodopa reduction was an acceptable strategy in ameliorating HDC and LDD only. Adjunctive therapy benefited all dyskinesia types, although the majority of patients (12/17) helped by selegiline had LDD or LDC. Generally, low doses of dopamine agonists were helpful (bromocriptine < 20 mg/day; pergolide < 2 mg/day). When adding adjunctive therapy (except for selegiline or controlled-release carbidopa/levodopa), concomitant reduction in daily dose of levodopa was not an effective strategy to decrease dyskinesias. Serial trials of multiple drug regimens are useful in these patients.

Authors+Show Affiliations

Department of Neurology, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick 08903.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8147565

Citation

Mark, M H., and J I. Sage. "An Analysis of Treatment Options and Outcome in Patients With Parkinson's Disease and Severe Dyskinesias." Annals of Clinical and Laboratory Science, vol. 24, no. 1, 1994, pp. 12-21.
Mark MH, Sage JI. An analysis of treatment options and outcome in patients with Parkinson's disease and severe dyskinesias. Ann Clin Lab Sci. 1994;24(1):12-21.
Mark, M. H., & Sage, J. I. (1994). An analysis of treatment options and outcome in patients with Parkinson's disease and severe dyskinesias. Annals of Clinical and Laboratory Science, 24(1), 12-21.
Mark MH, Sage JI. An Analysis of Treatment Options and Outcome in Patients With Parkinson's Disease and Severe Dyskinesias. Ann Clin Lab Sci. 1994 Jan-Feb;24(1):12-21. PubMed PMID: 8147565.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An analysis of treatment options and outcome in patients with Parkinson's disease and severe dyskinesias. AU - Mark,M H, AU - Sage,J I, PY - 1994/1/1/pubmed PY - 1994/1/1/medline PY - 1994/1/1/entrez SP - 12 EP - 21 JF - Annals of clinical and laboratory science JO - Ann Clin Lab Sci VL - 24 IS - 1 N2 - Forty-one patients with Parkinson's disease and severe dyskinesias were analyzed retrospectively to determine if some general principles would emerge to aid physicians handling this complication of treatment. Dyskinesia type (high dopa chorea [HDC], low dopa chorea [LDC], high dopa dystonia [HDD], and low dopa dystonia [LDD]) predicted response to treatment and whether or not levodopa dose reduction would benefit dyskinesias without producing unacceptable "offs." High dopa chorea improved best but at the expense of increased "off" time, followed by LDD, HDD, and LDC. Levodopa reduction was an acceptable strategy in ameliorating HDC and LDD only. Adjunctive therapy benefited all dyskinesia types, although the majority of patients (12/17) helped by selegiline had LDD or LDC. Generally, low doses of dopamine agonists were helpful (bromocriptine < 20 mg/day; pergolide < 2 mg/day). When adding adjunctive therapy (except for selegiline or controlled-release carbidopa/levodopa), concomitant reduction in daily dose of levodopa was not an effective strategy to decrease dyskinesias. Serial trials of multiple drug regimens are useful in these patients. SN - 0091-7370 UR - https://www.unboundmedicine.com/medline/citation/8147565/An_analysis_of_treatment_options_and_outcome_in_patients_with_Parkinson's_disease_and_severe_dyskinesias_ L2 - https://medlineplus.gov/movementdisorders.html DB - PRIME DP - Unbound Medicine ER -