L-DOPA for Parkinson's disease-a bittersweet pill

Eur J Neurosci. 2019 Feb;49(3):384-398. doi: 10.1111/ejn.14119. Epub 2018 Sep 16.

Abstract

3,4-dihydroxy-L-phenylalanine (L-DOPA) is the gold standard treatment for Parkinson's disease. It has earned that title through its highly effective treatment of some of the motor symptoms in the early stages of the disease but it is a far from perfect drug. The inevitable long-term treatment that comes with this chronic neurodegenerative condition raises the risk significantly of the development of motor fluctuations including disabling L-DOPA-induced dyskinesia. Being unsurpassed as a therapy means that understanding the mechanisms of dyskinesia priming and induction is vital to the search for therapies to treat these side effects and allow optimal use of L-DOPA. However, L-DOPA use may also have consequences (positive or negative) for the development of other interventions, such as cell transplantation, which are designed to treat or repair the ailing brain. This review looks at the issues around the use of L-DOPA with a focus on its potential impact on advanced reparative interventions.

Keywords: L-DOPA-induced dyskinesia; basal ganglia; graft-induced dyskinesia; motor complications.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antiparkinson Agents / adverse effects
  • Antiparkinson Agents / therapeutic use
  • Cell Transplantation / adverse effects
  • Dyskinesia, Drug-Induced / drug therapy
  • Humans
  • Levodopa / adverse effects*
  • Levodopa / therapeutic use
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / therapy

Substances

  • Antiparkinson Agents
  • Levodopa