Dopamine metabolism in the central nervous system after discontinuation of L-dopa therapy in patients with Parkinson disease

J Neurol Sci. 1984 Nov-Dec;66(2-3):151-63. doi: 10.1016/0022-510x(84)90003-0.

Abstract

The dopamine turnover rate in the central nervous system (CNS) of parkinsonian patients was studied by means of the intravenous probenecid test during drug holiday (DH) and alternate day L-dopa therapy (ADDT). After L-dopa therapy was stopped, the dopamine turnover rate decreased more rapidly in patients with the marked wearing-off phenomenon than that in patients without fluctuation of symptoms. The lumbar CSF concentrations of L-dopa and 3-O-methyldopa of patients with and without wearing-off phenomenon were similar during L-dopa therapy. DH improved the effect of L-dopa on parkinsonian symptoms; it did not affect, however, the metabolism of exogenous L-dopa. The dopamine turnover rate in the CNS before L-dopa therapy or on on-days did not differ between patients tolerating and those not tolerating ADDT. However, it was significantly lower on off-days in patients not tolerating ADDT than in those tolerating ADDT. The relationship between dopamine storage in the CNS and the response to L-dopa therapy is discussed.

MeSH terms

  • Adult
  • Aged
  • Brain / drug effects*
  • Brain / metabolism
  • Carbidopa / metabolism
  • Carbidopa / therapeutic use*
  • Dopamine / metabolism*
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Half-Life
  • Humans
  • Levodopa / metabolism
  • Levodopa / therapeutic use*
  • Male
  • Metabolic Clearance Rate
  • Middle Aged
  • Parkinson Disease / drug therapy*
  • Probenecid

Substances

  • Levodopa
  • Carbidopa
  • Probenecid
  • Dopamine