Treatment of Parkinsonism With Levodopa

Abstract

Some turn this sickness yet might take, Even yet. But he: "What drug can make A wither'd palsy cease to shake?" "The Two Voices" —Tennyson 1833 FOR MORE than a century, the treatment of parkinsonism has relied on a variety of compounds whose limited therapeutic efficacy depend upon their central parasympatholytic effects. The shortcomings of these agents, notably their inability to completely reverse the signs and symptoms or materially alter the progressive disabling nature of the disorder and the high incidence of disturbing side effects, are well appreciated. Under the most optimal circumstances, the best that can be expected from their judicious administration is a 20% reduction in the severity of symptoms with a modest improvement of functional capacity. The demonstration within the past decade of the presence of dopamine in the brain localized chiefly in the striatum and substantia nigra1,2and the subsequent discovery of its depletion