Long-term 24-hour duodenal infusion of levodopa: Outcome and dose requirements
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Short-term IV 24-hour levodopa infusion has been shown to improve motor variability and dyskinesias in patients with Parkinson disease (PD) with motor fluctuations.1 Longer-term around-the-clock enteral infusion of levodopa (n = 1) showed declining motor performance although the infusion rate was rapidly increased.2 It has been proposed that tolerance develops as a result of long continuous infusions of levodopa and dopamine agonists.3 Nighttime-only levodopa infusion has been reported in one case with immediate improvement of nocturnal akinesia.4 Duodenal/jejunal levodopa/carbidopa infusion (Duodopa) has evolved into a treatment alternative in patients with advanced PD.5 It is recommended for daytime use partly because of convenience for the patient and partly because of fear of tolerance development. Because nighttime disability and sleep disturbance are common problems for patients with advanced PD,6 oral dopaminergic medication is sometimes used during nighttime to improve sleep. We report retrospective data on five cases with continuous …
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Letters: Rapid online correspondence
- Long-term 24-hour duodenal infusion of levodopa: Outcome and dose requirements
- John G. Nutt, Oregon Health & Science University, Department of Neurology OP-32, Portland, Oregon 97201nuttj@ohsu.edu
Submitted February 13, 2006 - Reply from the Authors
- Dag Nyholm, Dept of Neuroscience, Neurology, Uppsala University Hospital, SE-75185 Uppsala, Swedendag.nyholm@neurologi.uu.se
- Rasmus Jansson, MD, Sundsvall, Sweden Thomas Willows, MD, Stockholm, Sweden Ingela Nilsson Remahl, MD, PhD, Stockholm, Sweden
Submitted February 13, 2006 - Long-term 24-hour duodenal infusion of levodopa: Outcome and dose requirements
- Dirk Deleu, Department of Neurology (Medicine), Hamad Medical Corporation, P.O. Box 3050, Doha, State of Qatardoc_deleu@hotmail.com
- Yolande Hanssens
Submitted February 13, 2006
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