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Smoothing out the Ups and Downs
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The progressive loss of nigrostriatal dopaminergic neurons with advancing disease exposes the trough between every dose of levodopa in Parkinson’s disease. This is due to the combination of a loss of native dopamine production to fill in this interdose interval and a reduction in dopaminergic terminals to take up and release dopamine long beyond its short plasma half-life. The clinical result is wearing off—an awareness in patients of returning symptomatology while waiting for their next dose. Where consistent and impacting negatively on function on any level, there are a number of initial oral approaches to smooth out dopaminergic stimulation before more invasive advanced therapeutic options need to be considered.
Title: Smoothing out the Ups and Downs
Description:
The progressive loss of nigrostriatal dopaminergic neurons with advancing disease exposes the trough between every dose of levodopa in Parkinson’s disease.
This is due to the combination of a loss of native dopamine production to fill in this interdose interval and a reduction in dopaminergic terminals to take up and release dopamine long beyond its short plasma half-life.
The clinical result is wearing off—an awareness in patients of returning symptomatology while waiting for their next dose.
Where consistent and impacting negatively on function on any level, there are a number of initial oral approaches to smooth out dopaminergic stimulation before more invasive advanced therapeutic options need to be considered.
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