Treatment of levodopa-induced motor complications

Fabrizio Stocchi, Michele Tagliati, C. Warren Olanow

Research output: Contribution to journalArticlepeer-review

Abstract

Chronic levodopa treatment for Parkinson's disease patients is frequently associated with the development of motor complications such as end-of-dose wearing-off and dyskinesias. In this review, we provide an overview of the strategies available for dealing with these problems. Medical management includes manipulation of levodopa dosing to establish the optimum treatment schedule, improving levodopa absorption, catechol-O-methyl transferase-inhibition (COMT), Monoamine oxidase-B (MAO-B) inhibition, dopaminergic agonists, amantadine, and continuous dopaminergic infusions. Surgical procedures and particularly deep brain stimulation are also reviewed. It should be noted that none of these treatments has been shown to provide anti-parkinsonian efficacy that is greater than what can be achieved with levodopa. We highlight the importance of initiating therapy with a treatment strategy that reduces the risk that a Parkinson's disease patient will develop motor complications in the first place. Key Words: Advanced PD, dyskinesias, motor fluctuations, levodopa dopamine agonists, COMT inhibitors, MAO-B inhibitors.

Original languageEnglish
JournalMovement Disorders
Volume23
Issue numberSUPPL. 3
DOIs
Publication statusPublished - 2008

Keywords

  • Advanced Parkinson's disease
  • Dopamine agonists
  • Dyskinesias
  • Levodopa
  • Motor fluctuations

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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