Parkinson's disease in the elderly: response to and optimal spacing of night time dosing with levodopa.

Leeman, A. L.; O'neill, C. J. A.; Nicholson, P. W.; Deshmukh, A. A.; Denham, M. J.; Royston, J. P.; Dobbs, R. J.; Dobbs, S. M.

doi:10.1111/j.1365-2125.1987.tb03223.x

Cited by 62 publications

(33 citation statements)

References 28 publications

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“…Two Class I studies evaluated the effect of levodopa/carbidopa on sleep quality in PD. 27,28 One study found that levodopa/carbidopa administered at bedtime improved sleep quality from 67% to 93% using a visual analog scale (VAS). 27 The other Class I study found that levodopa/carbidopa slow release tablets did not improve the number of hours slept, number of awakenings, sleep latency, or general sleep satisfaction.…”

Section: Sleep Dysfunction What Treatments Are Effective For Excessimentioning

confidence: 99%

“…27,28 One study found that levodopa/carbidopa administered at bedtime improved sleep quality from 67% to 93% using a visual analog scale (VAS). 27 The other Class I study found that levodopa/carbidopa slow release tablets did not improve the number of hours slept, number of awakenings, sleep latency, or general sleep satisfaction. 28 However, there was a significant improvement in mean nocturnal akinesia score in the levodopa-treated group.…”

Section: Sleep Dysfunction What Treatments Are Effective For Excessimentioning

confidence: 99%

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Practice Parameter: Treatment of nonmotor symptoms of Parkinson disease [RETIRED]

et al. 2010

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Objective: Nonmotor symptoms (sleep dysfunction, sensory symptoms, autonomic dysfunction, mood disorders, and cognitive abnormalities) in Parkinson disease (PD) are a major cause of morbidity, yet are often underrecognized. This evidence-based practice parameter evaluates treatment options for the nonmotor symptoms of PD. Articles pertaining to cognitive and mood dysfunction in PD, as well as treatment of sialorrhea with botulinum toxin, were previously reviewed as part of American Academy of Neurology practice parameters and were not included here. Methods:A literature search of MEDLINE, EMBASE, and Science Citation Index was performed to identify clinical trials in patients with nonmotor symptoms of PD published between 1966 and August 2008. Articles were classified according to a 4-tiered level of evidence scheme and recommendations were based on the level of evidence. Results and Recommendations:Sildenafil citrate (50 mg) may be considered to treat erectile dysfunction in patients with Parkinson disease (PD) (Level C). Macrogol (polyethylene glycol) may be considered to treat constipation in patients with PD (Level C). The use of levodopa/carbidopa probably decreases the frequency of spontaneous nighttime leg movements, and should be considered to treat periodic limb movements of sleep in patients with PD (Level B). There is insufficient evidence to support or refute specific treatments for urinary incontinence, orthostatic hypotension, and anxiety (Level U). Future research should include concerted and interdisciplinary efforts toward finding treatments for nonmotor symptoms of PD. Neurology The Quality Standards Subcommittee (QSS) of the American Academy of Neurology (AAN) develops scientifically sound, clinically relevant practice parameters to aid in the practice of neurology. This article evaluates treatment options for nonmotor symptoms of Parkinson disease (PD).While PD is considered a disorder characterized by motor symptoms, nonmotor symptoms are an integral part of this syndrome. These symptoms can be as troublesome as motor symptoms and impact activities of daily living, though they are often underrecognized by health care professionals.1,2 The nonmotor symptoms reviewed for this guideline were autonomic dysfunction (gastrointestinal disorders, orthostatic hypotension, sexual dysfunction, urinary incontinence), sleep disorders (restless legs syndrome, periodic limb movements of sleep, excessive daytime somnolence, insomnia, REM sleep behavior disorder), fatigue, and anxiety. Articles pertaining to cognitive and mood dysfunction in PD, as well as treatment of sialorrhea with botulinum toxin, were reviewed as part of previous AAN practice parameters 3,4 and were not included here.

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Section: Sleep Dysfunction What Treatments Are Effective For Excessimentioning

confidence: 99%

Section: Sleep Dysfunction What Treatments Are Effective For Excessimentioning

confidence: 99%

Practice Parameter: Treatment of nonmotor symptoms of Parkinson disease [RETIRED]

et al. 2010

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“…Direct effects on the sleep and wake systems may depend on dose and timing of the medications. For example, levodopa 200 mg in the evening may improve subjective sleep quality [ 22 ], but continuous dopaminergic therapy has been shown to worsen sleep fragmentation [ 23 ]. Non-selective MAO-B-inhibitors have been reported to cause both daytime sleepiness and sleep disruption, possibly due to an amphetamine-like metabolite [ 24 ] that has not been reported with selective MAO-Binhibitors [ 25 ].…”

Section: Definitionmentioning

confidence: 97%

Insomnia in Parkinson’s Disease

Park

Comella

2015

Disorders of Sleep and Circadian Rhythms in Parkinson's Disease

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“…Lateral displacement of the patient's centre of gravity in bed [8] and axial rotation about the longitudinal axis whilst recumbent [11] were monitored continuously on relevant nights.…”

Section: Subsequent Single Dose Challengesmentioning

confidence: 99%

Objective evidence for tolerance, against a background of improvement, during maintenance therapy with controlled release levodopa/carbidopa

Bowes

Dobbs

Henley

et al. 1992

Eur J Clin Pharmacol

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We have investigated whether the potential benefits of a controlled release formulation of levodopa (200 mg)/carbidopa (50 mg), Sinemet CR, are realised during maintenance therapy. Eight sufferers from idiopathic Parkinsonism, mean age 69.9 y, were studied: all exhibited "end of dose" effect within 4 h of a dose of their maintenance therapy with levodopa (100 mg)/carbidopa (25 mg) in a conventional release formulation, Sinemet Plus. They received, in random order, initial single dose challenges with one tablet of Sinemet Plus, one and two tablets of Sinemet CR and placebo alone, each on a separate day. After a mean of 21 weeks on maintenance therapy with Sinemet CR, subsequent single dose challenges with Sinemet CR and placebo were made. Objective measures of performance and blood sampling for assay of plasma concentrations of levodopa and the major peripheral metabolite, 3-0-methyldopa (30MD) were carried out immediately before (10.00 h) and serially until 6 h after each challenge. The overall mean stride length was significantly greater in relation to the subsequent (679 mm) than the initial (517 mm) placebo challenge. Moreover, stride length immediately before the challenges was significantly greater on the subsequent occasions. Improved performance, also seen for free walking speed, was not explained by plasma levodopa or 30MD concentrations. In the initial challenges, the mean increment in stride length achieved by active treatment, as compared with placebo, did not differ significantly between the one (210 mm) and two (235 mm) tablet doses of Sinemet CR: a maximal response had been obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

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Parkinson's disease in the elderly: response to and optimal spacing of night time dosing with levodopa.

Cited by 62 publications

References 28 publications

Practice Parameter: Treatment of nonmotor symptoms of Parkinson disease [RETIRED]

Practice Parameter: Treatment of nonmotor symptoms of Parkinson disease [RETIRED]

Insomnia in Parkinson’s Disease

Objective evidence for tolerance, against a background of improvement, during maintenance therapy with controlled release levodopa/carbidopa

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