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Stanley Fahn, MD

Arch Neurol. 1999;56:529-535.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

The introduction of effective doses of levodopa for the treatment of Parkinson disease (PD)^1-2 was a revolutionary step in overcoming symptoms of a progressive neurodegenerative disease. This took place a little more than 30 years ago, and still, today, levodopa remains the most effective drug for the reversal of symptoms of PD.^1-2 If there were no associated adverse effects with long-term use, treatment of PD would be a simple matter. But most of the physician's effort in providing optimum care of patients with PD is in trying to overcome all too common adverse effects of levodopa.

THE NATURE OF THE PROBLEMS

Motor Complications With Levodopa Therapy

Motoric adverse effects of dyskinesias and clinical fluctuations ("wearing-off" and "on-off" phenomena) often develop after patients have been treated with levodopa for a period of time. After 5 years of treatment, 75% of patients no longer have a smooth, stable, and effective response.³ It was not long after the introduction of . . . [Full Text of this Article]

The Question of Levodopa Toxicity

HOW DO NEUROLOGISTS DEAL WITH THE ABOVE PROBLEMS?

A CONTROLLED CLINICAL TRIAL TO DETERMINE IF LEVODOPA ALTERS THE NATURAL HISTORY OF PD: THE ELLDOPA TRIAL

From the Department of Neurology, Columbia University College of Physicians & Surgeons, New York, NY.

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