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Complications of Long-Term Levodopa Therapy Treatments by Taryn Simpson When patients are first diagnosed with Parkinson's disease, most neurologists prescribe levodopa therapy. Levodopa therapy is generally effective for one to five years. This period of time is sometimes called "The honeymoon period" as symptoms are mild and Parkinson's disease patients are able to take low doses of medication. However, this levodopa therapy will eventually require higher and higher doses to control the symptoms. Usually Parkinson's disease patients begin suffering from increasing symptoms about six years after diagnosis. Many patients also develop peak-dose dyskinesia consisting of choreiform twisting, or movements that occur when central dopamine levels are peaking. It is at this time when treatment for the patient becomes critical. It limits the amount of dopaminergic therapy that can be used on the patient. While a higher dose of medication is needed to control the stronger symptoms, higher doses also mean more pronounced dyskinesia. This hypersensitivity may result from exposing post-synaptic receptors to rapidly fluctuating levodopa-derived dopamine levels. This leaves the patient caught between the proverbial rock and a hard place. As described above, the balancing act of finding just the right medication dosage to control the symptoms can be very difficult. The rollercoaster of dopamine levels can wreak havoc on patients. Some patients will develop dementia or other cognitive issues which complicate treatment. Others will simply have more pronounced symptoms. Yet, there are still those patients who will be able to control their symptoms for 15 years or more. Everyone is different and progression of Parkinson's will be unique to each patient. If you notice your symptoms increasing, see your neurologist to discuss the best course of action. Rayilyn Brown Director AZNPF Arizona Chapter National Parkinson Foundation [log in to unmask] ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn