Review Article
Clinical Features, Pathophysiology, and Treatment of Levodopa-Induced Dyskinesias in Parkinson’s Disease
| Practical suggestions for pharmacological management of LID |
| (1) The optimal therapeutic approach for LID is to try avoiding their development | (2) Start PD treatment with an agonist if possible, particularly in young onset patients | (3) Save levodopa as long as you can hold the patient’s requirements for daily life activities | (4) Adjust the drug schedule: reduce total daily doses and/or shorten the intake intervals | (5) Add amantadine 200–400 mg/day | (6) Low doses of quetiapine or clozapine may be helpful | (7) Propose continuous drug delivery devices: duodenal levodopa/carbidopa gel or subcutaneous apomorphine | (8) For refractory cases, when indication is set by an expert and the risks are assumable by the patient, surgery is the treatment of choice |
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