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LEVODOPA FOR PARKINSONISM IN ELDERLY AND DEMENTED PATIENTS
Author(s) -
BROE GERALD A.,
CAIRD F. I.
Publication year - 1973
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1973.tb110594.x
Subject(s) - levodopa , parkinsonism , medicine , contraindication , anticholinergic , dementia , regimen , pediatrics , surgery , parkinson's disease , disease , alternative medicine , pathology
Twenty‐one patients whose ages ranged from 68 to 85 years who had idiopathic parkinsonism (18 also had dementia) were treated with levodopa, in small increments (0.125 gm every four days) and low maintenance doses (average, 1.7 gm). Twelve of the 16 patients who completed six months of levodopa therapy had significant benefit despite advanced age, severe disability, and dementia. Mental function improved in nine of the 13 demented patients who completed the six months of therapy. Neuropsychiatric side effects were mild and infrequent when levodopa was used alone. Anticholinergic drugs in the demented subjects appeared to act synergistically with levodopa and to produce neuropsychiatric side effects rather than additional benefit. The incidences of cardiac and gastrointestinal side effects were similar to those seen in other trials, but the gradual initiation of therapy reduced the severity. Elderly patients and those in a deteriorated condition with parkinsonism should be considered for levodopa therapy with a slow increment low‐dosage regimen. Dementia is not a contraindication and may lessen during treatment with this regimen; however, the long‐term effects of levodopa on mental function are unknown.