The pharmacological therapeutic management of levodopa-induced dyskinesias in patients with Parkinson's disease.
Identifieur interne : 003869 ( Main/Exploration ); précédent : 003868; suivant : 003870The pharmacological therapeutic management of levodopa-induced dyskinesias in patients with Parkinson's disease.
Auteurs : O. Rascol [France]Source :
- Journal of neurology [ 0340-5354 ] ; 2000.
English descriptors
- KwdEn :
- MESH :
- chemical , adverse effects : Levodopa.
- complications : Parkinson Disease.
- drug therapy : Dyskinesia, Drug-Induced, Parkinson Disease.
- physiopathology : Dyskinesia, Drug-Induced.
- Animals, Humans.
Abstract
The clinical management of levodopa-induced dyskinesia is difficult. Once present, dyskinesias are only partially improved by lowering the daily dose of levodopa and co-administering a D2 dopamine agonist. Therefore it appears to be necessary to use an NMDA-antagonist, such as amantadine, as an antidyskinetic agent. Clozapine may also improve dyskinesia without worsening akinesia, but it requires strict haematological monitoring. A long-term continuous subcutaneous infusion of apomorphine significantly reduces the dose of levodopa required, thereby markedly reducing dyskinesia, but this is difficult from a practical point of view. If none of these pharmacological strategies is successful, surgery should then be considered. Since the management of established levodopa-induced dyskinesia is difficult and often disappointing, efforts should be encouraged to try to prevent the occurrence of dyskinesia, before levodopa priming. This seems to be best achieved by the use of D2 dopamine agonists in the early stages of the disease, before, or in combination with, levodopa.
PubMed: 10991666
Affiliations:
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Le document en format XML
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Rascol</name><affiliation wicri:level="3"><nlm:affiliation>Laboratoire de Pharmacologie Mèdicale et Clinique, Faculté de Médicine, Toulouse, France. rascol@cict.fr</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Laboratoire de Pharmacologie Mèdicale et Clinique, Faculté de Médicine, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2000">2000</date><idno type="RBID">pubmed:10991666</idno><idno type="pmid">10991666</idno><idno type="wicri:Area/PubMed/Corpus">001333</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001333</idno><idno type="wicri:Area/PubMed/Curation">001292</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001292</idno><idno type="wicri:Area/PubMed/Checkpoint">001292</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">001292</idno><idno type="wicri:Area/Ncbi/Merge">000137</idno><idno type="wicri:Area/Ncbi/Curation">000137</idno><idno type="wicri:Area/Ncbi/Checkpoint">000137</idno><idno type="wicri:doubleKey">0340-5354:2000:Rascol O:the:pharmacological:therapeutic</idno><idno type="wicri:Area/Main/Merge">003E76</idno><idno type="wicri:Area/Main/Curation">003869</idno><idno type="wicri:Area/Main/Exploration">003869</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">The pharmacological therapeutic management of levodopa-induced dyskinesias in patients with Parkinson's disease.</title><author><name sortKey="Rascol, O" sort="Rascol, O" uniqKey="Rascol O" first="O" last="Rascol">O. Rascol</name><affiliation wicri:level="3"><nlm:affiliation>Laboratoire de Pharmacologie Mèdicale et Clinique, Faculté de Médicine, Toulouse, France. rascol@cict.fr</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Laboratoire de Pharmacologie Mèdicale et Clinique, Faculté de Médicine, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author></analytic><series><title level="j">Journal of neurology</title><idno type="ISSN">0340-5354</idno><imprint><date when="2000" type="published">2000</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Animals</term><term>Dyskinesia, Drug-Induced (drug therapy)</term><term>Dyskinesia, Drug-Induced (physiopathology)</term><term>Humans</term><term>Levodopa (adverse effects)</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (drug therapy)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Dyskinesia, Drug-Induced</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Dyskinesia, Drug-Induced</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Animals</term><term>Humans</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The clinical management of levodopa-induced dyskinesia is difficult. Once present, dyskinesias are only partially improved by lowering the daily dose of levodopa and co-administering a D2 dopamine agonist. Therefore it appears to be necessary to use an NMDA-antagonist, such as amantadine, as an antidyskinetic agent. Clozapine may also improve dyskinesia without worsening akinesia, but it requires strict haematological monitoring. A long-term continuous subcutaneous infusion of apomorphine significantly reduces the dose of levodopa required, thereby markedly reducing dyskinesia, but this is difficult from a practical point of view. If none of these pharmacological strategies is successful, surgery should then be considered. Since the management of established levodopa-induced dyskinesia is difficult and often disappointing, efforts should be encouraged to try to prevent the occurrence of dyskinesia, before levodopa priming. This seems to be best achieved by the use of D2 dopamine agonists in the early stages of the disease, before, or in combination with, levodopa.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Midi-Pyrénées</li><li>Occitanie (région administrative)</li></region><settlement><li>Toulouse</li></settlement></list><tree><country name="France"><region name="Occitanie (région administrative)"><name sortKey="Rascol, O" sort="Rascol, O" uniqKey="Rascol O" first="O" last="Rascol">O. Rascol</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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