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Influence of COMT inhibition on levodopa pharmacology and therapy. Catechol O-methyltransferase (COMT) is an important enzyme that is linked directly to therapy with levodopa. Considering the demonstrated mechanism of action and pharmacologic profiles of COMT inhibitors, it is reasonable to hypothesize that these agents would improve the disability associated with Parkinson's disease. Two basic classes of COMT inhibitors are being studied in patients with PD: those that act exclusively extracerebrally or peripherally (e.g., entacapone) and those that cross the blood-brain barrier (e.g., tolcapone). With COMT inhibition, greater peripheral bioavailability of levodopa occurs in humans without an enhancement of peak plasma levels. It is reasonable to suggest that COMT inhibition will be associated with prolonged effects of levodopa in PD, without increased peak dose toxicity in the form of dyskinesias and hallucinations. Neurology 1998 May;50(5 Suppl 5):S26-30 Goetz CG Rush-Presbyterian St. Luke's Medical Center, Chicago, Illinois 60612, USA PMID: 9591519, UI: 98252193 <http://www.ncbi.nlm.nih.gov/PubMed/> janet paterson 52 now / 41 dx / 37 onset 613 256 8340 po box 171 almonte ontario canada K0A 1A0 a new voice: <http://www.geocities.com/SoHo/Village/6263/> <[log in to unmask]>