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October 1979

Opiate Antagonists and Parkinson's Disease

Author Affiliations

University Department of Neurology Institute of Psychiatry and King's College Hospital Medical School London SE5 8AF, England

Arch Neurol. 1979;36(10):661. doi:10.1001/archneur.1979.00500460095021

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To the Editor.—  We were interested in the recent report of Nutt et al in the Archives (35:810-811, 1978) describing the failure of naltrexone to affect the conditions of patients with Parkinson's disease. We also found that naloxone hydrochloride, another potent opiate antagonist, has no obvious effect on the major manifestations of Parkinson's disease, on the therapeutic benefit of levodopa, or on levodopainduced dyskinesias. Four patients with idiopathic Parkinson's disease were given 0.8 mg of intravenous (IV) naloxone hydrochloride and a fifth patient was given 2 mg of IV naloxone hydrochloride. There was no subsequent change in tremor (evident in three patients), rigidity, akinesia, or posture. All patients had taken levodopa, usually with carbidopa (Sinemet), two to three hours earlier, but the manifestations of their Parkinson's disease were only partially reversed; there was neither an improvement nor a deterioration after administration of naloxone hydrochloride. Freezing episodes continued in two patients in

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