Objective: In patients with advanced Parkinson disease, it is possible to obtain a response to duodopa, if the dose is adjusted appropriately, even taking periods of sleep into account.

Background: The long-duration response (LDR) to levodopa is an important component of the therapeutic response to the drug in Parkinson’s disease (PD). The true magnitude of the long-duration response to levodopa remains unknown.

Method: We report 1 patient (age: 65 years) with advanced Parkinson´s disease (12 and of evolution, stage III/V of Hoehn and Yahr). With habitual oral therapeutic scheme the patients presented fluctuations, chorea “on” and RAMs and off dystonia in the legs. Enterally administered levodopa/carbidopa gel (Duodopa®) was indicated.

Results: After treatment with duodopa (duodopa dose: morning dose: 9 ml- 180 mg-; continuous dose: 3,5 ml/hr-70 mg/h; extra-dose of 2 ml-40) “continouos” dopaminergic stimulation dramatically ameliorate “on-off” fluctuations and choreic “on” dyskinesias but patient began, in the afternoom, with very severe dystonia and RAMs in the legs. Patient improved during the night. The increase infusion dose caused Chorea widespread and with the decrease in the dose worsened the parkinsonism. Finally infusion was maintained only during the night with improvement (no dyskinesias and good motor situation) during the day.

Conclusion: After duodopa infusion during the night, long-duration response with a half-life of hours, improved patient situation during the day.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/long-duration-response-to-levodopa-in-advanced-parkinson-disease/