The Role of L-Dopa in Parkinson's Disease Treatment (2024)

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For a large number of people living with Parkinson’s disease, levodopa, or L-dopa, is a first-choice therapy recommended by many doctors. This medication, which has been in use since the late 1960s, helps many people better control symptoms of Parkinson’s disease.

If your doctor recommends levodopa, it is important for you to understand how it works inside the brain. One of the keys to living well with Parkinson’s disease is knowing more about it. Once you’re armed with this knowledge, you and your doctor can make the best treatment decisions possible.

Levodopa is the gold standard Parkinson’s treatment because it addresses a main problem of the disease: low dopamine levels. Inside the brain, certain chemicals, called neurotransmitters, transmit signals from nerve cells to other nerve cells. One of these chemicals, known as dopamine, is responsible for the initiation of movement, along with other functions. You may have already heard of dopamine–it’s also the chemical responsible for the brain’s “reward system.”

When a person develops Parkinson’s disease, dopamine-producing cells in a specific area of the brain are damaged. As time goes on, the damage gets worse, causing levels of dopamine in the brain to fall. This makes symptoms of Parkinson’s disease more likely to occur.

It’s not known exactly why some people develop Parkinson’s, but doctors believe that your genes and certain environmental factors may contribute. Common symptoms of Parkinson’s disease include balance and gait problems, bradykinesia (slowed movements), limb rigidity, speech changes, tremors, and writing changes.

Over one million people in the United States live with Parkinson’s disease. Although the disease can’t be cured, symptoms can be managed to help preserve your quality of life. Your doctor may recommend one or several treatments to help control symptoms, such as:

• Levodopa is the most potent drug for Parkinson’s disease that we know of today. Your doctor may also suggest other medications, like dopamine agonists, to achieve maximum symptom control.
• Physical or occupational therapy. Preserving the ability to move normally is a top priority if you have Parkinson’s. Working with a physical or occupational therapist can help you stay active and improve your quality of life.
• For some, a special type of surgery known as deep brain stimulation (DBS) helps reduce Parkinson’s disease symptoms. DBS may also help you have a better, more sustained response to levodopa.

The discovery of levodopa helped revolutionize the treatment of Parkinson’s disease. At its most basic level, levodopa is the precursor to dopamine–it’s what dopamine is made of.

When a person takes levodopa, the drug easily crosses the blood-brain barrier (BBB) and builds up inside the brain. Once levels are high enough, levodopa is converted to dopamine, and Parkinson’s symptoms lessen or go away entirely. For many people, using levodopa is one of the most effective ways to manage symptoms of Parkinson’s disease.

Although a great many people control Parkinson’s symptoms well with levodopa, the drug can still cause some unpleasant side effects. The most common side effects of levodopa include:

• Confusion
• Dizziness
• Dyskinesia (uncontrolled, involuntary movements)
• Loss of appetite
• Low blood pressure
• Nausea
• Vomiting

Today, levodopa is usually prescribed right alongside a drug called carbidopa to relieve and prevent nausea and vomiting. The drug may also be combined with other medications to achieve better symptom control. If you’re taking levodopa for the first time, keep your doctor up-to-date about any side effects you experience.

Unfortunately for some people, the benefits of levodopa therapy seem to wear off over time. “Off” periods with Parkinson’s occur when levodopa isn’t working and symptoms return. These episodes are more likely to happen after several years of taking levodopa to manage Parkinson’s disease. The exact cause of this loss of effectiveness isn’t well understood. However, starting at a lower dose of levodopa may help delay this problem. Also, adding other drugs to your treatment regimen can extend L-dopa’s effectiveness to prevent or shorten “off” periods.

For many people, treatment with levodopa is absolutely essential to living well with Parkinson’s disease. The drug helps replace much-needed dopamine within the brain, which in turn helps you better manage some symptoms of Parkinson’s. If your doctor recommends levodopa, be sure to discuss what you should expect to help with other treatment decisions.