"Levodopa, the absolute most effective drug for Parkinson's disease, is known to have a short-lasting effect requiring repeated administration throughout the day. In clinical practice there is the use of speaking of the ON phase, in which the short-lasting effect is present, and of the OFF phase in which it is absent.
Studies on levodopa have always been limited by the fact that it is not possible to find Parkinsonian patients in advanced stages of the disease who are not already on levodopa therapy, and it is not possible to discontinue therapy for ethical reasons.
The results of a study in Africa of 30 Parkinsonian patients with a mean age at onset of 58 years and a mean disease duration of 7.1 years, who had never been treated with levodopa, have now been published.
The effects of levodopa, administered alone at a variable dose according to body weight, on motor function were measured by measuring the score on the international UPDRS scale after the first administration and after 1 and 2 years of therapy (in 8 patients also after 4 years of therapy).
The first administration made it possible to obtain a significant motor improvement, with a reduction of the UPDRS motor score on average equal to about 40%, regardless of the duration of the disease. After 1 year of therapy, levodopa resulted in a persistent benefit, even 12 hours after the last dose, when the short-lasting effect was no longer there (OFF phase) even in the most advanced stages of the disease, and likewise after 2 and 4 years of therapy; the extent of the improvement was around 30%. In other words, these results document that there is a long-lasting response to levodopa, which determines a persistent benefit, which protects the patient even in the OFF phases.
During the study, there were 8 cases of temporary discontinuation of therapy due to supply problems. Therapy gradually returned to initial scores: the complete disappearance of the improvement required an interruption of more than 15 days in a patient who had been sick for 8 years, while a one-week interruption was sufficient in a patient who had been sick for 20 years.
The authors draw two conclusions:
Documentation and extent of long-lasting response to levodopa represent additional reasons for starting low-dose levodopa early in the disease.
Measurement of motor function after levodopa is stopped for 12 hours - a parameter generally used in disease progression studies - is not a reliable parameter."
Emh ... In my opinion,
this last sentence could be embarrassing for the PD research world.
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Gioc
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interesting topic. a few years ago, in the earlier stages of the disease, i went on holiday and forgot my meds. after about 12 days, the drugs seemed to be completely gone and i began to tremor. kinda lines up.
Thank you for making this a separate post. I think this article gets to the issue of long term levodopa benefits more directly and succinctly than other articles I have read. I am glad I began taking carbidopa- levodopa (sinemet) when I did. One one hand, it makes me wonder if the red hat is responsible for the improvements I have experienced during the past few months or if it's just that the sinemet is working better/longer. On the other hand, this extremely important for newly diagnosed PwP. As a person who once had Levodopa Phobia, I am glad to know that it may confer symptom relief for more than a few hours. Thanks again, Gio!
An anecdote: Doctor C. always cited this researches of Ghana (this one derives from the previous one).
He was a fan of levodopa and he imposed on me from the start ,6 years ago,with a considered high dose of madopar + madopar extended release four time at day (which I do not say now), with the well-known supplements.
Jim, I'd like to know how many people can claim that their sense of smell returned with levodopa. Hyposmia does not improve with l-dopa therapy. That should help you answer the question.
In addition to the above earlier links, see the below. You can find many more through some research.
"Hyposmia in people with PD does not respond to PD medications, including dopaminergic agents, dopamine agonists, or anticholinergic compounds. Currently, there is no known treatment that can improve the sense of smell in PD patients."
That was one of my husbands first symptoms long before dx, in fact years before. He’s been on Madopar for 5 years plus but the sense of smell did seem to reappear sometimes afterB1 supplements. After Red light and broccoli tea, as per Wriga his sense of smell is better, not perfect but he often notices floral scents from Zoflora or similar or my perfume or lavender, and comments on it.
I noticed my own selective anosmia (cat urine, etc) when I went on a strict keto and was able to smell things keenly during ketosis (ketones as fuel) that I couldn't normally around the time. Mine also got better after B1 (plus co-factors) and also upping my zinc status.
Jim said: "I think this article gets to the issue of long term levodopa benefits more directly and succinctly than other articles I have read."
I think this is the key. Back in August, the original thread promoting this research paper just had a link to the paper itself, plus a quote from the abstract. That thread only got 2 responses.
For this thread, Gio has provided a translation of a short and very readable article about that research paper. There are already many more than 2 responses.
I used to read a lot of research papers, but these days I prefer to read quality articles about research papers. For me, the AlzForum website is a good source for such articles.
Thank you , very readable , but so were all the other studies that confirmed that small doses at the beginning were very beneficial, but still the new people will write post asking for natural , non pharma treatment and they then stay off their prescribed medication thus ruining what could have been very happy productive years that could have been used for exercise and preparation. I do no understand where they are getting the misinformation from. I am not aware of a single study suggesting they might be better not taking low dose LC.
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