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Volume 360:935-936 February 26, 2009 Number 9
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Levodopa for Parkinson's Disease

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by LeWitt, P. A.
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To the Editor: In his Clinical Therapeutics article, LeWitt (Dec. 4 issue)1 emphasizes that levodopa is still the pivotal treatment in Parkinson's disease, despite the disabling motor complications caused by the intermittent, pulsatile supply of levodopa.2,3,4 Since these complications can be mitigated by strategies that extend levodopa's pharmacokinetic profile, we wish to draw attention to the clinical application of the concept of continuous dopaminergic stimulation. The aim is to reverse the priming process.2,3,4 Continuous intravenous infusion of levodopa produces a prolonged, stable clinical response.4 Continuous intraduodenal infusion of carbidopa–levodopa through a gastrostomy port reduced motor complications more effectively than all . . . [Full Text of this Article]



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