Treatment of Dyskinesia in Patients with Parkinson’s Disease

[Farooqji]

Drs Rajesh Pahwa, Daniels Kremens and Fernando Pagan provide an overview of current treatment options for treatment of dyskinesia in patients with Parkinson’s Disease.

neurologylive.com/view/trea...

[Smittybear7]

Very interesting. It seems like they just don't know exactly what causes what. Thanks for sharing.

[johntPM]

I'm talking here specifically about levodopa induced dyskinesia (LID). As one of the presenters says, you can usually reduce LID by reducing levodopa to below the LID threshold. But, this comes at the cost of reducing the efficacy of the dose; with, at the least, some motor control being lost.

What I don't understand is whether the amantadine is often effective because:

- the daily trace of levodopa concentrations shows a saw-tooth pattern following, but lagged behind, the doses of levodopa. Amantadine is a dopamine agonist, which can, using the ideas of Levodopa Equivalent Dose, in some sense, be added to levodopa. This comes after conversion for different strengths has been made. And, takes into account, the fact that amantadine has a longer half-life than levodopa (about 20 hours, as compared with about 90 minutes with L/C), This suggests that by properly timing the doses of amantadine with some of the levodopa one can reduce the maximum levels of levodopa without sacrificing motor control; and, hence, reducing dyskinesia.

- the amantadine has some different mechanism of action.

[hmm777]

Props to Dr. Pahwa, who happens to be my MDS.

[gomelgo]

could someone please clear this up for me? Is dyskenisia only caused by meds or does it ever happen to pwp who don't take meds?