Optimizing levodopa therapy for Parkinson's disease with levodopa/carbidopa/entacapone: implications from a clinical and patient perspective.

Neuropsychiatric Disease and Treatment
David J Brooks

Abstract

After 40 years of clinical experience, levodopa remains the gold standard treatment for Parkinson's disease (PD) despite the recent emergence of a host of new therapies. Some physicians are cautious when prescribing levodopa because of its association with motor complications. Evidence now suggests that levodopa-associated complications are a result of deep troughs in delivery of levodopa to the brain caused by the short plasma half-life of conventional levodopa formulations (levodopa and a dopa decarboxylase inhibitor [DDCI]). Dosing strategies, such as dose increases and dose fractionation, may be effective in the short term. For the longer-term, levodopa/carbidopa/entacapone provides pharmacokinetically optimized levodopa therapy that significantly increases the plasma half-life and bioavailability of levodopa, providing more consistent plasma levodopa levels without deep troughs. Evidence from clinical trials in PD patients experiencing re-emergence of symptoms due to wearing-off has consistently shown that levodopa/DDCI and entacapone significantly increases ON-time and affords greater functionality, as measured by the Unified Parkinson's Disease Rating Scale (UPDRS) with conventional levodopa. These trials have also shown...Continue Reading

References

Jan 1, 1984·Clinical Neuropharmacology·J G Nutt, J H Fellman
Aug 18, 2001·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·V V MyllyläUNKNOWN FILOMEN Study Group
Jun 22, 2002·BMJ : British Medical Journal·Keith WheatleyRichard Gray
Feb 27, 2003·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·J P LarsenUNKNOWN NOMESAFE Study Group
May 2, 2003·Movement Disorders : Official Journal of the Movement Disorder Society·Irene LitvanUNKNOWN Movement Disorders Society Scientific Issues Committee
Jun 5, 2003·Clinical Neuropharmacology·Dag NyholmSten-Magnus Aquilonius
Jun 14, 2003·The Cochrane Database of Systematic Reviews·R KatzenschlagerA Lees
Jul 24, 2003·Journal of Neurology, Neurosurgery, and Psychiatry·D J BrooksUNKNOWN UK-Irish Entacapone Study Group
Jul 21, 2004·Archives of Neurology·Robert G HollowayUNKNOWN Parkinson Study Group
Sep 24, 2004·Movement Disorders : Official Journal of the Movement Disorder Society·Stéphane ChapuisFranck Durif
Jul 23, 2005·Movement Disorders : Official Journal of the Movement Disorder Society·Katherine A GrossetDonald G Grosset
Oct 8, 2005·Movement Disorders : Official Journal of the Movement Disorder Society·Thomas MüllerDirk Woitalla
Oct 8, 2005·Movement Disorders : Official Journal of the Movement Disorder Society·Wolfgang H OertelJohannes Schwarz
Oct 14, 2005·Journal of Neurology·Stanley Fahn, UNKNOWN Parkinson Study Group
Oct 14, 2005·Journal of Neurology·Fabrizio Stocchi
Feb 21, 2006·Lancet Neurology·K Ray ChaudhuriUNKNOWN National Institute for Clinical Excellence
Feb 21, 2006·Annals of Neurology·Anthony H V Schapira, Jose Obeso
Jun 30, 2006·Expert Opinion on Pharmacotherapy·Fabrizio Stocchi
Sep 8, 2006·Movement Disorders : Official Journal of the Movement Disorder Society·Olivier RascolUNKNOWN 056 Study Group

❮ Previous
Next ❯

Citations

Mar 29, 2014·Revue neurologique·P Cesaro, L Defebvre
Apr 23, 2009·Expert Opinion on Drug Delivery·Antonio Di StefanoLaura Serafina Cerasa
Jan 21, 2014·Expert Opinion on Drug Metabolism & Toxicology·Livia Dézsi, László Vécsei
Mar 10, 2017·NeuroImage. Clinical·Jae Woo ChungDavid E Vaillancourt
Jan 4, 2017·Geriatric Nursing·Fung Kei Cheng
Jan 4, 2018·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Fatma HaddadRafik Karaman
Feb 27, 2017·IEEE Transactions on Bio-medical Engineering·Teresa Arroyo-GallegoLuca Giancardo
Jun 9, 2016·Neurology and Therapy·Aline Aparecida FoppaMareni Rocha Farias
Nov 20, 2016·Bioanalysis·Marcia Cristina Teixeira Dos SantosAndre Nogueira da Costa
Feb 6, 2018·Journal of Speech, Language, and Hearing Research : JSLHR·Laura L PittsJulie A G Stierwalt
Dec 14, 2017·International Journal of Molecular Sciences·Loredana LeggioNunzio Iraci
Jul 21, 2017·NPJ Systems Biology and Applications·Marouen Ben Guebila, Ines Thiele
Mar 13, 2020·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Xiaoli LiaoKe Li
Mar 23, 2019·Nutrients·Ana M PugaGregorio Varela-Moreiras
Oct 3, 2020·Chaos·Florence Véronneau-VeilleuxFahima Nekka
Dec 9, 2020·Clinical Neurology and Neurosurgery·Mickey E AbrahamYehuda Herschman
Feb 5, 2021·Science Translational Medicine·Rob PowersAdeeti V Ullal
Aug 22, 2020·ACS Sensors·Hazhir TeymourianJoseph Wang
Nov 27, 2020·Metabolic Engineering·Dario BreitelCathie Martin
Apr 3, 2021·The Journal of Pharmacology and Experimental Therapeutics·Nicola L BriceMark B Carlton
Nov 18, 2018·Journal of Medicinal Chemistry·Pradipta DasJon T Njardarson
Aug 17, 2021·Frontiers in Neuroscience·Matthew BernardinisMandar S Jog

❮ Previous
Next ❯

Methods Mentioned

BETA
pharmacotherapy

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.