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Concern About Long-Term Levodopa Use in Parkinson's Patients is Unfounded : Presented at ANA
By Jill Stein
Special to DG News
NEW YORK, NY -- October 17, 2002 -- Concern about an increased rate of disease progression or severity of symptoms resulting from long-term use of levodopa in Parkinson's disease (PD) patients is not justified, researchers said here October 15 at the 127th Annual Meeting of the American Neurological Association (ANA).
Reports based on in vitro cell culture studies have raised the issue that levodopa administration can produce irreversible toxic reactions to dopaminergic neurons.
To clarify whether these toxic reactions also occur in humans treated with levodopa, Dr. Melvin Yahr, from Mount Sinai School of Medicine, in New York, New York, United States, reviewed the charts of 36 patients who had been treated primarily with levodopa with or without carbidopa for at least 20 years and who received on occasion ancillary antiparkinsonian agents for a limited period of time. The researchers studied the course of their disease, the response to levodopa, the complications encountered and the functional state, as well as survival.
In addition, the investigators evaluated the autopsies of 33 patients who had been on levodopa for various periods of time. Their pathological changes were compared with patients who had not received levodopa or other dopaminergic agents.
On average, patients reached an advanced stage of their PD in 23 years.
Postmortem studies showed morphologic changes characteristic of PD -- nigral cell loss and Lewy body formation. Surviving nigral neurons were present and appeared normal.
Dr. Yahr said that the data do not support the in vitro findings that levodopa is neurotoxic to dopaminergic neurons. He said that the present study confirms that levodopa can be used safely in patients with PD.
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