Start Hesitation — A Side Effect of Long-Term Levodopa Therapy

Abstract

THE side effects of levodopa therapy in patients with Parkinson's disease are numerous and prevalent. Reports of short-term clinical trials emphasize the frequency of gastrointestinal and cardiovascular toxic reactions to this drug.1 2 3 Appraisals of long-term therapy are still scarce, but those available have indicated that as tolerance to the gastrointestinal and cardiovascular side effects gradually develops, other new adverse reactions appear.4 , 5 Barbeau4 , 5 labeled these toxic delayed reactions "the long-term levodopa syndrome." The first component of this syndrome was an increased frequency of involuntary dyskinetic or choreoathetoid movements even at progressively smaller levodopa doses. Secondly, in some patients subtle mental and . . .