Oral L-dopa solution therapy of menstrual-related fluctuations in Parkinson's disease.
Garcia-Moreno JM, Paramo L, Chacon J. Parkinsonism Relat D/son/2003; 10(1): 53-54.
The authors are affiliated with the Servicio de Neurologia, Hospital Universitario Virgen Macarena, Seville, Spain. In this case re port they describe their success with using an extemporaneously prepared oral solution containing L-dopa/carbidopa/ ascorbic acid to treat a woman previously diagnosed with Parkinson's disease (PD) when she was 40 years old. Over the course of 10 years she was treated with carbidopa/L-dopa, amantadine and selegiline and eventually was stabilized on 500 mg of L-dopa per day divided in five 100-mg doses. At age 50, concurrent with the onset of her menopause, she developed severe fluctuations in Parkinson's symptoms at the time of menses. At this time she was hospitalized for assessment and the menstrual-related fluctuations proved refractory to treatment with conventional therapy: L-dopa, bromocriptine and selegiline. The oral solution was given 5 days before menses began and continued until 5 days after her menses ended. Treatment with bromocriptine and selegiline was continued as well; treatment with L-dopa tablets resumed the same day her menses ended. Why did the oral solution work? The authors believe that "the treatment with L-dopa solution may allow a better intestinal absorption because its gastric emptying occurs continuously. Therefore, serie drug levels may become more stable and thus the dopaminergic stimulation more continuous than with L-dopa tablets." Of particular interest to compounding pharmacists is the fact that the preparation of the oral solution is described in detail.
Copyright International Journal of Pharmaceutical Compounding Jul/Aug 2004
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