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December 14, 1970


Author Affiliations

Palo Alto, Calif.

JAMA. 1970;214(11):2059. doi:10.1001/jama.1970.03180110067022

To the Editor.—  A great disservice may have been done many patients and physicians by publication of a letter by Sacks et al (213:2270, 1970) reporting "adverse" effects of levodopa which are at variance with most clinical reports.1-3I have directed the levodopa program at Standford University for 2 1/2 years and have followed 250 patients (100 of them for more than one year, 20 for two years). The most benevolent view of the great discrepancy between the Sacks et al report and that of other investigators is that they have an institutionalized population of patients of whom half are reported to have postencephalitic Parkinson's disease, whereas almost all patients in our study and other large studies have had idiopathic Parkinson's disease. However, nowhere in the letter do Sacks et al define whether given side effects occurred selectively in postencephalitic or in idiopathic cases.They have observed psychosis