Pharmacy World & Science

, Volume 30, Issue 1, pp 1–2 | Cite as

Possible role for chlorpheniramine in the treatment of l-DOPA induced dyskinesia in Parkinson’s disease

  • Petros N. KaramanakosEmail author
  • Periklis Pappas
  • Marios Marselos
Letter to the Editor

Dear Editor,

Dopamine (DA) replacement therapy with l-3,4-dihydroxyphenylalanine (l-DOPA) remains the most effective medication for the symptomatic relief of Parkinson’s disease (PD). However, chronic l-DOPA treatment is often complicated by a variety of involuntary movements, termed l-DOPA-induced dyskinesia (LID), which represents one of the major limitations in the treatment for PD. Depending on clinical presentation and chronology after a dose of l-DOPA, LID can be classified in peak-dose, diphasic, and off period dyskinesias. Peak-dose dyskinesia occurs at the time of the highest brain concentration of l-DOPA and represents the most common type of LID. The current pharmacological treatment of this form of dyskinesia involves, as a first measure, the reduction of individual l-DOPA doses, which indeed can lead to improvement of dyskinesia, exacerbating however the symptoms of the disease. Slow-release l-DOPA preparations or spreading of the daily dose of L-DOPA into smaller but...


Chlorpheniramine l-DOPA Parkinson’s disease Pharmacotherapy 


  1. 1.
    Kannari K, Yamato H, Shen H, Tomiyama M, Suda T, Matsunaga M. Activation of 5-HT(1A) but not 5-HT-(1B) receptors attenuates an increase in extracellular dopamine derived from exogenously administered L-DOPA in the striatum with nigrostriatal denervation. J Neurochem 2001;76:1346–53.PubMedCrossRefGoogle Scholar
  2. 2.
    Tomiyama M, Kimura T, Maeda T, Kannari K, Matsunaga M, Baba M. A serotonin 5-HT1A receptor agonist prevents behavioral sensitization to L-DOPA in a rodent model of Parkinson’s disease. Neurosci Res 2005;52:185–94.PubMedCrossRefGoogle Scholar
  3. 3.
    Olanow CW, Damier P, Goetz CG, Mueller T, Nutt J, Rascol O et al. Multicenter, open-label, trial of sarizotan in Parkinson’s disease patients with levodopa-induced dyskinesias (the SPLENDID Study). Clin Neuropharmacol 2004;27:58–62.PubMedCrossRefGoogle Scholar
  4. 4.
    Karamanakos PN, Pappas P, Marselos M. Involvement of the brain serotonergic system in the locomotor stimulant effects of chlorpheniramine in Wistar rats: implication of postsynaptic 5-HT1A receptors. Behav Brain Res 2004;148:199–208.PubMedCrossRefGoogle Scholar
  5. 5.
    Arbouw MEL, Movig KLL, Neef C, Guchelaar H-J, Egberts TCG. Influence of initial use of serotonergic antidepressants on antiparkinsonian drug use in levodopa-using patients. Eur J Clin Pharmacol 2007;63:181–87.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Petros N. Karamanakos
    • 1
    • 2
    Email author
  • Periklis Pappas
    • 1
  • Marios Marselos
    • 1
  1. 1.Department of Pharmacology, Medical SchoolUniversity of IoanninaIoanninaGreece
  2. 2.Department of NeurosurgeryUniversity Hospital of KuopioKuopioFinland

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