Modification of Parkinsonism — Chronic Treatment with L-Dopa

TLDR

A peripheral dopa‑decarboxylase inhibitor lowered the required L‑dopa dose and eliminated anorexia and nausea in one patient. In 28 Parkinsonism patients, gradually increased L‑dopa doses produced modest to dramatic improvements that were sustained for up to two years, with minimal toxicity, transient mental effects, and nausea managed by slow titration, though some patients experienced involuntary movements.

Abstract

Slowly increasing oral doses of L-3,4-dihydroxyphenylalanine (L-dopa) induced at least partial improvement of some manifestations in a series of 28 patients with Parkinsonism. Improvement of performance was graded as modest in four, moderate in four, marked in 10 and dramatic in 10. This was usually sustained for periods up to two years. Evidence of toxicity was signaled by few of the variables monitored. Mental effects included enhanced interest, improved memory, transitory sleeplessness and nervousness. Nausea and vomiting were largely circumvented by slowing of the increases of the daily dose. A peripheral dopadecarboxylase inhibitor diminished the therapeutic dose of L-dopa required and eliminated anorexia and nausea in one case. Neurologic side effects consisted of involuntary movements ranging from fleeting to severe.