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Controversies in Neurology
March 2000

Is Levodopa Toxic?

Author Affiliations

From the Department of Neurology, University of Miami School of Medicine, Miami, Fla.

 

VLADIMIRHACHINSKIMD, DSc

Arch Neurol. 2000;57(3):408-410. doi:10.1001/archneur.57.3.408

IN RECENT years there has been an increasing chorus of concern regarding the use of levodopa in patients with Parkinson disease. Despite its acknowledged and recognized role as the single most potent agent for the treatment of Parkinson disease, questions regarding its toxicity have emerged. The expressed concern is that levodopa induces or accelerates dopaminergic cell death, resulting in more rapid disease progression. Clinical neurologists at first greeted these concerns with skepticism because levodopa is well known to be the single most effective treatment to improve motor symptoms in Parkinson disease and has been demonstrated to improve longevity in patients with this disorder.13 However, repeated publication of the levodopa toxicity hypothesis began to sway neurologic opinion. In addition, the repeated "warnings" issued in various Parkinson disease lay organization magazines intensified the fear of levodopa therapy in patients and their families. Herein, we examine the myth of levodopa toxicity.

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