Apomorphine infusion and the long-duration response to levodopa in advanced Parkinson's disease

Fabrizio Stocchi, Alfredo Berardelli, Laura Vacca, Luca Barbato, Alessandra Monge, Giampietro Nordera, Stefano Ruggieri

Research output: Contribution to journalArticle

Abstract

The authors investigated the long-duration response to levodopa in advanced Parkinson's disease. Eight patients with advanced Parkinson's disease disabled by severe ON/OFF fluctuations treated by chronic daytime subcutaneous apomorphine infusion with supplemental oral levodopa were studied. On day 1, oral levodopa was withdrawn at 4:00 PM and on the following morning subcutaneous apomorphine infusion was continued at the same rate without levodopa therapy. While receiving apomorphine alone, seven of the eight patients turned ON, and their usual dyskinesias returned. The ON phase persisted for 60 to 100 minutes (mean, 185.7 minutes) but then, despite continued, constant-rate apomorphine infusion to stabilize plasma levels, switched to an OFF phase. The authors conclude that the clinical effect of apomorphine is sustained by levodopa long-duration response. This effect is probably the result of postsynaptic mechanisms. In patients with advanced Parkinson's disease, the long-duration response to levodopa is present although slightly diminished.

Original languageEnglish
Pages (from-to)151-155
Number of pages5
JournalClinical Neuropharmacology
Volume26
Issue number3
DOIs
Publication statusPublished - May 2003

Keywords

  • Apomorphine
  • Levodopa
  • Long-duration response
  • Parkinson's disease

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Clinical Neurology
  • Neuroscience(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)

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