Objective: To determine the effect and risk factors of a single dose levodopa induced OH in PD

Background: Levodopa (LD) is widely recognised as the most effective therapy in Parkinson’s disease (PD). Orthostatic hypotension (OH) secondary to levodopa therapy has been described, but the acute effect have not been welled studied

Methods: A cross-sectional study was conducted amongst PD patients at Maharaj Nakorn Chiang Mai Hospital during July to December 2016. The demographic data were recorded. The single dose of LD was given to the patients who withdraw LD before the tested date. Blood pressures (BP) on lying and 3 minutes after upright were measured at baseline, and after intake LD every 30 minutes until 120 minutes. OH was defined by drop in systolic and/or diastolic BP ≥20 or 10 mmHg within 3 minutes after upright. A group of OH and non-OH were analyzed

Results: Forty-three subjects were enrolled into study. Male and female gender were not different. Mean age and PD duration were 65.7 and 5.4 years. Incidence of LD induced OH was 16.3%. Age, PD duration and staging were not significant between two groups. There were statistical significant of LD first dose and daily dose between OH and non-OH group (mean±SD, p-value: 164.3±61.0 vs. 125±49.6 mg, 0.04 and 600±236.3 vs. 401.4±164.5 mg/day, 0.04). Wearing-off, low baseline BP and concomitant use MAO-B inhibitor (Odds ratio, 95% confidence interval:14, 0.56-848.18) or pramipexole (5.5, 0.71-44.69) also contributed as factors related to OH

Conclusions: LD can induce OH in PD who has trends to developed postural events, especially at high dose and had risk factors

References: S Perez-Lloret, et al. Factors related to orthostatic hypotension in Parkinson’s disease. Parkinsonism Relat Disord. 2012 Jun;18(5):501-5.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/levodopa-induced-orthostatic-hypotension-in-parkinsons-disease-a-single-dose-response-study/