Standard and Controlled-Release Levodopa/Carbidopa in Patients With Fluctuating Parkinson's Disease on a Protein Redistribution Diet

Karstaedt, Patricia J.; Pincus, Jonathan H.; Coughlin, Steven S.

doi:10.1001/archneur.1991.00530160070016

Cited by 4 publications

(2 citation statements)

References 30 publications

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“…A total of 28 articles were identified from the key word searches and from the reference list of the selected articles 2, 3, 7–33. Twelve studies were excluded because they did not meet the inclusion criteria 8–19. Causes of exclusion are presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Unfortunately, it is worth mentioning that, although in the last four decades different levodopa formulations (slow/controlled‐release) have been developed and adjuvants have been introduced,35, 36 most studies have scantly described the therapy in use. In patients on PRD controlled‐release formulations have been associated with higher levodopa doses and longer periods of dyskinetic ON time,14 suggesting that patients with advanced PD are less tolerant to changes in drug plasma levels. The advice would be to redistribute daily protein intake in the early stages of the disease, when dopamine storage capacity by nigro‐striatal neurons still exists.…”

Section: Literature Overviewmentioning

confidence: 99%

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Low‐protein and protein‐redistribution diets for Parkinson's disease patients with motor fluctuations: A systematic review

Cereda

Barichella

Pedrolli³

et al. 2010

Movement Disorders

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The American Academy of Neurology suggests advising the redistribution of daily protein meal content to every Parkinson's disease (PD) patient with motor fluctuations during levodopa treatment. However, no comprehensive evaluation of this complementary therapy has been performed. A systematic review of intervention studies investigating the neurologic outcome of low-protein (<0.8 g/kg of ideal weight/day) and protein-redistribution diets in patients with PD experiencing motor fluctuations during levodopa treatment. All studies (uncontrolled or randomized) investigating a low-protein and/or a protein-redistribution diet (LPD and PRD) and involving patients with PD with motor fluctuations were included, provided that sufficient information on dietary protein content and neurologic outcome measures was available. We identified 16 eligible studies, but they were markedly heterogeneous. There was not enough evidence to support the use of LPD. Response to PRD seemed very good. Acceptability appeared high upon introduction, but it seemed to progressively decrease over time. On average, PRD resulted in improved motor function, but also complications occurred. At the beginning, drop-outs were due to levodopa side effects rather than unsatisfactory benefits. Long-term adherence was more affected by changes in dietary habits than by diet-related side effects. Efficacy and benefits appeared to be higher when the intervention was proposed to subjects in the early stages of PD. PRD can be safely advised to fluctuating patients with PD, but those in whom benefits override the possible inconveniences still need to be identified. The long-term effects of PRD on nutritional status should be evaluated and true effectiveness in clinical practice should be reassessed, given the changes in levodopa formulations and the introduction of several adjuvants (levodopa degradation inhibitors and/or dopamine agonists).

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Section: Resultsmentioning

confidence: 99%

Section: Literature Overviewmentioning

confidence: 99%

Low‐protein and protein‐redistribution diets for Parkinson's disease patients with motor fluctuations: A systematic review

Cereda

Barichella

Pedrolli³

et al. 2010

Movement Disorders

View full text Add to dashboard Cite

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Parkinson’s Disease

Korenblum,

Korczyn,

Gurevich

2025

International Encyclopedia of Public Health

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Effects of dietary factors on levodopa pharmacokinetics

Fernández

García

Diez

et al. 2010

Expert Opinion on Drug Metabolism & Toxicology

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An understanding of the pharmacokinetics of any drug is crucial for the establishment of its optimal therapeutic regimen, but this assumes a special importance with levodopa, due to its extensive presystemic metabolism, rapid absorption in the proximal small intestine and short plasma half-life. Major problems with levodopa treatment are the fluctuations in clinical response experienced in patients with advanced Parkinson's disease that sometimes are related to the peripheral pharmacokinetics of levodopa. Studies of levodopa interactions are very important to improve patient response to this drug.

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Standard and Controlled-Release Levodopa/Carbidopa in Patients With Fluctuating Parkinson's Disease on a Protein Redistribution Diet

Cited by 4 publications

References 30 publications

Low‐protein and protein‐redistribution diets for Parkinson's disease patients with motor fluctuations: A systematic review

Low‐protein and protein‐redistribution diets for Parkinson's disease patients with motor fluctuations: A systematic review

Parkinson’s Disease

Effects of dietary factors on levodopa pharmacokinetics

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