Naturally occurring amino acid, similar to dopamine agonists.
Levodopa is utilized in Parkinson’s disease and in restless leg syndrome.
May be combined with carbidopa to reduce side effects.
Dopamine agonists and particularly carbidopa/levodopa are the most effective treatment for Parkinson’s.
Virtually all patients treated for Parkinson’s disease will, at some point, receive levodopa.
It is an immediate precursor to dopamine, which can cross the blood brain barrier.
It allows the depleted number of dopaminergic neurons to reduce more dopamine and alleviate symptoms.
Levodopa is the most effective drug for motor symptom treatment in Parkinson’s disease.
Levodopa is given with carbidopa, a peripheral decarboxylase inhibitor preventing levodopa conversion to dopamine in the peripheral circulation and liver.
It is usually paired with carbidopa, which blocks metabolism of levodopa in the periphery, and increases CNS bioavailability and lessons peripheral side effects, particularly nausea.
Adverse effects include: nausea, vomiting, orthostatic hypotension, dyskinesia, hallucinations and psychosis.
Dyskinesia often limits the dose that can be used, and is the major reason why other medications or surgical interventions are considered.
Patients may report fluctuations as the dose wears off, freezing episodes especially when walking, and dance like movements, chorea, referred to as levodopa induced dyskinesia.
Levodopa treatments improve visual outcomes and stabilize neovascular age related macular degeneration related retinal changes.
Levodopa reduces VEGF levels and may be effective as an adjuvant anti-VEGF injection therapy.