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July 1978

Paradoxical Response to Dopaminergic Agents in Parkinsonism

Author Affiliations

From the Department of Neurological Sciences, Rush-Presbyterian-St Luke's Medical Center, Chicago.

Arch Neurol. 1978;35(7):453-455. doi:10.1001/archneur.1978.00500310055011

• A patient with the classical stigmata of parkinsonism was treated on three separate occasions with levodopa, a combination of levodopa and carbidopa, and lergotrile mesylate, a direct-acting dopamine-receptor agonist. All three treatment regimens resulted in doserelated increases in parkinsonian features. To our knowledge, this response has not been previously described. Lergotrile did not alter CSF homovanillic acid concentration. It is suggested that this rare paradoxical motor response to dopaminergic agents may be associated with dysfunction of the postsynaptic dopamine receptor site.

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