- Effects of L-DOPA Monotherapy on Psychomotor Speed and [11C]Raclopride Binding in High-Risk Older Adults With Depression. [Journal Article]
- BPBiol Psychiatry 2019 Apr 15
- CONCLUSIONS: By enhancing availability of dopamine, L-DOPA improved processing and gait speed in older adults with depression and significantly decreased [11C]raclopride binding in selected striatal subregions.
- Pharmacokinetics and efficacy of a novel formulation of carbidopa-levodopa (Accordion Pill®) in Parkinson's disease. [Journal Article]
- PRParkinsonism Relat Disord 2019 May 22
- CONCLUSIONS: AP technology demonstrated effective controlled-release PK performance and reduced motor response fluctuations in advanced PD patients. A phase 3 randomized controlled trial is currently underway.
- Inhaled levodopa (Inbrija) for Parkinson's disease. [Journal Article]
- MLMed Lett Drugs Ther 2019 May 20; 61(1572):73-74
- Old Drugs, New Delivery Systems in Parkinson's Disease. [Review]
- DADrugs Aging 2019 Jun 03
- Levodopa is the mainstay of treatment in Parkinson's disease (PD). As the disease progresses, variations in plasma levodopa levels lead to motor fluctuations. The common reasons behind variations in …
Levodopa is the mainstay of treatment in Parkinson's disease (PD). As the disease progresses, variations in plasma levodopa levels lead to motor fluctuations. The common reasons behind variations in the plasma levels include delayed gastric emptying, small intestinal bacterial overgrowth, protein interaction with levodopa absorption, and limited oral bioavailability of levodopa. Efforts to find newer delivery systems for older drugs to avoid the problems associated with oral delivery of medications are continuing. This review aims to provide up-to-date information about the newer delivery options for drugs used for PD and provides a summary of infusion therapy with apomorphine, modifications to other dopamine agonists, various oral formulations of carbidopa/levodopa, inhaled levodopa, intrajejunal infusion of levodopa, and sublingual apomorphine. The advantages, dose, and adverse effects of each treatment modality are reviewed. We also discuss several drugs under investigation, such as the subcutaneous carbidopa/levodopa infusion and subcutaneous rotigotine.
- Naturopathic Treatment of Gastrointestinal Dysfunction in the Setting of Parkinson's Disease. [Case Reports]
- IMIntegr Med (Encinitas) 2018; 17(4):44-50
- Parkinson's disease is associated with multiple nonmotor symptoms including gastrointestinal (GI) distress, which affect patients' activities of daily living and are traditionally treated by pharmace…
Parkinson's disease is associated with multiple nonmotor symptoms including gastrointestinal (GI) distress, which affect patients' activities of daily living and are traditionally treated by pharmaceutical agents aimed at symptom control. In this case, a 73-y-old female presented with 3 wk of constipation and acid reflux after a recent diagnosis of Parkinson's disease and initiation of carbidopa-levodopa 6 mo prior. A contributing factor was anosmia leading to a vast dietary change. All other etiologies were excluded via clinical history and physical exam. Dietary intervention was initiated as the foundational treatment and included increased consumption of vegetables to 5 servings per day, increased dietary fiber to 30 g per day, increased protein consumption, decreased sugar consumption, and increased hydration. These dietary changes were accompanied by symptomatic relief of acid reflux through apple cider vinegar and deglycyrrhizinated licorice as well as probiotic and magnesium citrate initiation for constipation. The patient had complete resolution of constipation and 50% improvement in acid reflux after 5 d and complete resolution of all symptoms after 1 mo. GI complications associated with neurologic disorders such as Parkinson's disease may be managed via foundational dietary changes with natural symptom control with similar outcomes as pharmaceutical management but without lasting side effects.
- Attempted Suicide in a Parkinsonian Patient Treated with DBS of the VIM and High Dose Carbidopa-Levodopa. [Case Reports]
- CRCase Rep Psychiatry 2019; 2019:2903762
- Parkinson's disease (PD) is a complex disease that is often treated with dopaminergic medications such as carbidopa-levodopa and now with innovative interventions such as deep brain stimulation (DBS)…
Parkinson's disease (PD) is a complex disease that is often treated with dopaminergic medications such as carbidopa-levodopa and now with innovative interventions such as deep brain stimulation (DBS). While PD frequently presents with depression and apathy, research must elucidate whether its treatment modalities have an additive or synergistic effect that can lead to an increased suicide risk. DBS has been associated with depression, behavioral changes, and suicidality while dopaminergic treatment has also been shown to cause behavioral changes such as hypersexuality and impulsivity. Considering the now frequent practice of utilizing both DBS and carbidopa-levodopa to treat PD, it is crucial to understand how to properly manage PD patients who are displaying this overlap in symptomology.
- Acute parkinsonism as an unexpected consequence of pituitary adenoma resection: A case report. [Case Reports]
- MMedicine (Baltimore) 2019; 98(17):e15261
- CONCLUSIONS: This case highlights an unexpected association between transsphenoidal resection of pituitary tumors and acute parkinsonism which is a treatable manifestation of EPM. Correction of hyponatremia following transsphenoidal pituitary resections should be preceded cautiously because even gradual correction of hyponatremia can produce myelinolysis.
- Large left posterior fossa meningioma presenting with quadriplegia in a woman with history of carbidopa-levodopa resistant parkinsonism. [Journal Article]
- NINeurol Int 2019 Mar 11; 11(1):7815
- A 56-year-old Afro-Trinidadian woman with a history of a carbidopa-levodopa resistance Parkinsonian-like syndrome for 2 years, presented with acute onset spastic quadriplegia and decreased responsive…
A 56-year-old Afro-Trinidadian woman with a history of a carbidopa-levodopa resistance Parkinsonian-like syndrome for 2 years, presented with acute onset spastic quadriplegia and decreased responsiveness. Diagnosis involved clinical and MR-imaging correlation consistent with a large left posterior fossa meningioma. Surgical removal of the tumor led to complete reversibility of the neurological manifestations associated with cerebellar tonsillar herniation beyond the foramen magnum and mass effect on the brainstem, cerebellum and midbrain regions. Pathological findings were typical of a meningioma. This case demonstrates the association of a large left posterior fossa meningioma and carbidopalevodopa resistant parkinsonism in an Afro-Trinidadian woman who presented with acute onset acute quadriplegia and decreased responsiveness. This case reminds clinicians that patients with dopa unresponsiveness and/or acute neurological deficit or deterioration should be worked up for other possible causes and adds to the literature on the association of parkinsonism and intracranial space occupying lesions.
- Orally inhaled levodopa (CVT-301) for early morning OFF periods in Parkinson's disease. [Journal Article]
- PRParkinsonism Relat Disord 2019 Mar 30
- CONCLUSIONS: Single doses of CVT-301 84 mg administered with oral carbidopa/levodopa for early morning OFF symptoms were well-tolerated, with no notable safety concerns.
New Search Next
- [Complications and troubleshooting at the initial introduction of Levodopa-carbidopa continuous infusion gel therapy: A single-center study]. [Journal Article]
- RSRinsho Shinkeigaku 2019 Apr 25; 59(4):177-184
- Levodopa-carbidopa intestinal gel (LCIG) therapy has been established as a device-aided treatment for advanced Parkinson's disease. We retrospectively investigated the issues related to LCIG therapy …
Levodopa-carbidopa intestinal gel (LCIG) therapy has been established as a device-aided treatment for advanced Parkinson's disease. We retrospectively investigated the issues related to LCIG therapy in patients with Parkinson's disease at our hospital from March 2014 to July 2018. The subjects were 18 patients including nine men and nine women. The mean duration of PD symptoms and motor fluctuation was 14.5 ± 5.9 and 7.2 ± 4.5 years, respectively. The mean age at initiation of LCIG was 60.1 ± 9.4 years and the mean treatment period was 21.1 ± 19.5 months. One hundred and sixteen LCIG-associated issues were observed, including pain at the gastrostomy site (23 cases), hypergranulation tissue (14 cases), skin redness and/or erosions (11 cases), cutaneous infections at the gastrostomy site (eight cases), percutaneous endoscopic gastrojejunostomy (PEG-J) tube occlusion in the gastrointestinal tract (19 cases), irremovable PEG-J tube (13 cases), dislocation of the PEG-J tube (six cases), and breakage of the connector (eight cases). The majority of these issues were easily diagnosed and could be managed by neurologists who are familiar with LCIG therapy.