Advertisement

Long-Term Responses of Parkinson’s Disease to Levodopa Therapy

  • U. K. Rinne
  • V. Sonninen
  • T. Siirtola
  • R. Marttila
Part of the Journal of Neural Transmission book series (NEURAL SUPPL, volume 16)

Abstract

The long-term responses of Parkinson’s disease to levodopa therapy were studied in the patient material followed-up for 9 years. Levodopa treatment alleviated the parkinsonian symptoms to a considerable degree and substantially improved the quality of life of the parkinsonian patients. However, after treatment for 2 to 3 years, a progressive deterioration of parkinsonian symptoms was observed accompanied by an increase in the incidence of dyskinesias, on-off phenomena, postural instability and dementia. An analysis of the mortality rates in the follow-up material of 349 patients showed that initially levodopa treatment decreased the excess mortality due to Parkinson’s disease. The ratios of observed to expected deaths ranged from 1.10 to 1.67. However, during the ninth year of treatment the ratio increased to 1.95 almost reaching the values obtained in the first years of levodopa treatment. Thus it appears that levodopa has only a limited period of usefulness in the treatment of Parkinson’s disease. Although levodopa very significantly improves parkinsonian symptoms, it does not arrest the pathological progress and modify the natural course of the disease.

Levodopa treatment with or without a decarboxylase inhibitor alleviates the symptoms of Parkinson’s disease to a considerable degree and substantially improves the quality of life of parkinsonian patients (Barbeau, 1969; Birkmayer, 1969; Cotzias et al., 1969; Yahr et al., 1969; Rinne et al., 1970). However, in spite of a good initial response, a progressive deterioration of parkinsonian symptoms has been observed after treatment with levodopa for several years, associated at the same time with an increase in the incidence of long- term side effects of levodopa treatment (see: Rinne, 1978).

In this paper we would like to describe our results on the responses of parkinsonian patients to long-term levodopa therapy.

Keywords

Excess Mortality Postural Instability Parkinsonian Patient Levodopa Therapy Parkinsonian Symptom 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Barbeau, A.: L-Dopa therapy in Parkinson’s disease. A critical review of nine years experience. Canad. med. Ass. J. 101, 791–800 (1969).Google Scholar
  2. Birkmayer, W.: Experimentelle Ergebnisse über die Kombinationsbehandlung des Parkinson-Syndroms mit L-Dopa und einem Decarboxylase- hemmer (Ro 4–4602). Wien. klin. Wschr. 81, 677–679 (1969).PubMedGoogle Scholar
  3. Cotzias, G. C., Papavasiliou, P. S., Gellene, R.: Modification of Parkinsonism-chronic treatment with L-Dopa. N. Engl. J. Med. 280, 337 to 345 (1969).PubMedCrossRefGoogle Scholar
  4. Diamond, S. G., Markham, Ch. H.: Present mortality in Parkinson’s disease: the ratio of observed to expected deaths with a method to calculate expected deaths. J. Neural Transm. 38, 259–269 (1976).PubMedCrossRefGoogle Scholar
  5. Hoehn, M. M., Yahr, M. D.: Parkinsonism: onset, progression and mortality. Neurology (Minneap.) 17, 427–442 (1967).Google Scholar
  6. Marttila, R.J., Rinne, U. K.: Changing epidemiology of Parkinson’s disease: Predicted effects of levodopa treatment. Acta neurol. Scand. 59, 80–87 (1979).PubMedCrossRefGoogle Scholar
  7. Rinne, U. K., Sonninen, V., Siirtola, T.: L-Dopa treatment in Parkinson’s disease. Eur. Neurol. 4, 348–369 (1970).PubMedCrossRefGoogle Scholar
  8. Rinne, U. K.: Recent advances in research on Parkinsonism. Acta neurol. Scand. 57, 77–113 (1978).CrossRefGoogle Scholar
  9. Yahr, M. D., Duvoisin, R. C., Shear, M.J.: Treatment of parkinsonism with levodopa. Arch. Neurol. (Chic.) 21, 343–354 (1969).CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 1980

Authors and Affiliations

  • U. K. Rinne
    • 1
    • 2
  • V. Sonninen
    • 1
  • T. Siirtola
    • 1
  • R. Marttila
    • 1
  1. 1.Department of NeurologyUniversity of TurkuTurkuFinland
  2. 2.Department of NeurologyUniversity of TurkuTurku 52Finland

Personalised recommendations