Levodopa treatment alleviates the motor symptoms that characterize Parkinson disease, but is associated with motor complications. Treatments that prolong the action of levodopa could potentially reduce the risk of these adverse events, but a new study reports that one such approach—entacapone as an adjunct to levodopa–carbidopa—is associated with earlier dyskinesia onset than with levodopa–carbidopa alone.
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Grace, A. A. & Bunney, B. S. The control of firing pattern in nigral dopamine neurons: single spike firing. J. Neurosci. 4, 2866–2876 (1984).
Smith, L. A. et al. Multiple small doses of levodopa plus entacapone produces continuous dopaminergic stimulation and reduces dyskinesia induction in MPTP treated drug naive primates. Mov. Disord. 20, 306–314 (2005).
Stocchi, F. et al. Initiating levodopa/carbidopa therapy with and without entacapone in early Parkinson disease: the STRIDE-PD study. Ann. Neurol. 68, 18–27 (2010).
Rascol, O. et al. A five year study of the incidence of dyskinesia in patients with early Parkinson's disease who were treated with ropinirole or levodopa. N. Engl. J. Med. 342, 1484–1491 (2000).
Parkinson Study Group. Pramipexole vs levodopa as initial treatment for Parkinson disease: a randomized controlled trial. JAMA 284, 1931–1938 (2000).
Kuoppamäki, M. et al. Comparison of pharmacokinetic profile of levodopa throughout the day between levodopa/carbidopa/entacapone and levodopa/carbidopa when administered four or five times daily. Eur. J. Clin. Pharmacol. 65, 443–455 (2009).
Heikkinen, H. et al. Entacapone improves the availability of L-dopa in plasma by decreasing its peripheral metabolism independent of L-dopa/carbidopa dose. Br. J. Clin. Pharmacol. 54, 363–371 (2002).
Block, G., Liss, C., Reines, S., Irr, J. & Nibbelink, D. Comparison of immediate-release and controlled release carbidopa/levodopa in Parkinson's disease. A multicenter 5-year study. The CR First Study Group. Eur. Neurol. 37, 23–27 (1997).
Dupont, E. et al. Sustained-release Madopar HBS compared with standard Madopar in the long-term treatment of de novo parkinsonian patients. Acta Neurol. Scand. 93, 14–20 (1996).
Mouradian, M. M., Heuser, I. J., Baronti, F. & Chase, T. N. Modification of central dopaminergic mechanisms by continuous levodopa therapy for advanced Parkinson's disease. Ann. Neurol. 27, 18–23 (1990).
J. J. Ferreira has acted as a consultant for and received honoraria for lectures from Lundbeck, Novartis and Teva Pharmaceuticals, he has also received research support from Lundbeck and Teva Pharmaceuticals. C. Sampaio declares no competing interests.
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Sampaio, C., Ferreira, J. Adjunctive entacapone therapy increases risk of dyskinesia. Nat Rev Neurol 6, 590–591 (2010). https://doi.org/10.1038/nrneurol.2010.158