DOI: https://doi.org/10.22141/2224-0713.3.97.2018.133682

Extended-release levodopa/carbidopa in the treatment of Parkinson’s disease

I.M. Karaban

Abstract


Parkinson’s disease occurs in about 1 out of 200 individuals and is the second after Alzheimer's disease most common neurodegenerative disease in the world. At the early stages of Parkinson’s disease, when motor symptoms do not impact the qua-lity of life, it is preferable to prescribe dopamine receptor agonists and monoamine oxidase B inhibitors. As the quality of life begins to deteriorate, patients need immediate-release levodopa/carbidopa, long-term treatment with this drug is associted with motor fluctuations and dyskinesias. The cause of motor fluctuations and dyskinesias is associated with the inability of dopaminergic neurons to provide continuous release of dopamine. Immediate-release levodopa/carbidopa at long-term administration causes a pulsatile stimulation — the mediator is “stormy” released, and then absents for a long time. To reduce the risk of complications, dopamine receptor agonists, monoamine oxidase B inhibitors, catechol-O-methyltransferase inhibitors are prescribed. If this is not enough, patients need extended-release levodopa/carbidopa adding or completely switching to it. Prolonged form due to the slow absorption of the drug from the intestine ensures the return of brain neurons to the continuous release of dopamine. As a result, motor fluctuations and dyskinesias decrease or completely disappear. The efficacies of both forms of levodopa in terms of motor symptoms of Parkinson’s disease and the profiles of their side effects were the same. Compliance is higher for extended-release levodopa/carbidopa due to the smaller number of doses taken per day.

Keywords


immediate-release levodopa/carbidopa; extended-release levodopa/carbidopa; motor fluctuations; dyskinesias; Parkinson’s disease

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