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Author: Admin | 2025-04-28
August 30, 2017 Levodopa was approved to treat Parkinson's disease (PD) over 50 years ago and today it remains the "gold standard" of treatment. As levodopa is the most effective medication to ease Parkinson's symptoms, most people will take it at some point in the course of their disease. Misconceptions surrounding it, though, can contribute to fear of starting it or taking optimal dosages. Here I address common myths about levodopa, but always discuss any apprehensions you may have about medications with your personal physician. Levodopa is the only drug for Parkinson's. This drug is the most commonly prescribed medication for Parkinson's disease, but dopamine agonists (e.g., Mirapex, or pramipexole) and MAO-B inhibitors (e.g., Azilect, or rasagiline) are some of the other medications available to manage Parkinson's motor symptoms. These can be used either instead of or together with levodopa. (Read more about Parkinson's drugs.) Levodopa loses effectiveness over time. After taking levodopa for some time, it certainly may feel like the drug is less effective. Often, higher and/or more frequent doses are required to control symptoms. However, this is mostly due to gradual worsening of the underlying disease rather than medication's effects diminishing. As long as you take it, levodopa will remain beneficial. But, if the natural progression of your disease requires higher levodopa doses, side effects -- including dyskinesia (irregular, involuntary, uncontrolled movement) -- can occur. This may lead to a dose reduction, which, in turn, may limit some of the drug's benefit on symptoms, such as tremor. (Note that some individuals may not tolerate a dose reduction, preferring dyskinesia to other symptoms.) Levodopa always causes dyskinesia. Although most people with PD eventually develop dyskinesia, not everyone does. Dyskinesia's uncontrolled movements often occur at the same time that other PD symptoms (e.g., tremor or rigidity) are suppressed. Major risk factors include higher levodopa doses, younger age at diagnosis and longer course of disease. Severity of dyskinesia varies greatly from person to person; it can look like mild leg fidgeting, bobbing of the head or body swaying. An extended-release form of the commonly prescribed drug amantadine was recently approved by the U.S. Food and Drug Administration (FDA), becoming the first drug specifically indicated to treat levodopa-induced dyskinesia. Several medical and surgical options for dyskinesia also are in development. (Find out more about dyskinesia.) Avoiding levodopa is the best way to treat Parkinson's. Because of the above concerns, some people
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