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Levodopa Myths

Levodopa has been approved by the FDA for over 50 years. It is the most common and effective medication for Parkinson's. Levodopa cannot reverse the disease, but it can help people live a more enjoyable life. It is not the only medication for Parkinson's, but it is the gold standard. However, there are a lot of misconceptions about the drug. Let's take a deep dive on the common myths around Levodopa.



Myths

1. Levodopa loses it's effectiveness over time.

Over time, people with PD will probably have to take more medication. This is not because the medications isn't as effective, but it is because the disease is progressing. As the disease progresses, there are fewer neurons in our brain that produce dopamine, so you may need more medication to supplement what your body is missing. It is important to note that Levodopa will address motor symptoms, so sometimes as the disease progresses you may have new non-motor symptoms. These symptoms will not respond to Levodopa. Non-motor symptoms include fatigue, sleep disturbances, depression, urinary and bowel changes, cognition changes, and blood pressure irregularities. So if you feel like you are taking more medications and it is not helping, talk with your doctor! You may be expecting the medication to help with symptoms it is not designed to help with.


2. You should delay starting Levodopa to delay onset of motor fluctuations.

The motor fluctuations means fluctuations with ON and OFF time. People with PD frequently experience symptom changes in between medication dosages when the medication was worn off or is not as effective. It has been reported that people may develop motor fluctuations and dyskinesias after being on Levodopa for a long time. However, in clinical trials it has been shown that the motor fluctuations and dyskinesias has more to do with how long you have had the disease, not how long you have been taking the medication. Studies also show that if you wait until the disease progresses to take the medication, you may have motor fluctuations sooner after taking the medication as compared to starting earlier.

It is important to note that Levodopa does not have to be started as soon as you are diagnosed! As long as your symptoms are not impacting your day to day function, there is no concern with postponing treatment. If your symptoms are stopping you from exercising, this may warrant taking medication.



3. Only take natural medications to treat PD.

Mucuna is typically a medication that is used as a natural alternative to Levodopa since it contains about 6-9% of levodopa. Mucuna does not contain carbidopa, which is an enzyme that allows our brain to uptake as much of the levodopa as possible, instead of losing it in the bloodstream. Carbidopa is what allows for a smaller dosage of medication to be so effective, because your body is using more of it with carbidopa! If your natural medication does not contain carbidopa, chances are your brain is not getting the dopamine it needs for it to be effective. Some people use natural medications along with their pharmaceutical mediations.


4. Levodopa causes awful side effects.

Some may experience fatigue such as nausea, fatigue, dizziness, and hallucinations. The important part is to work with your neurologist to determine that the dosage is right for you. Sometimes, additional medications are prescribed to treat any side effects that cannot be managed with a dosage change. Dyskinesias are a common side effect of levodopa, but changing the dosage can again help. Not everyone gets dyskinesia, but it is more common in those who are younger at diagnosis, take higher amounts of levodopa for long periods of time, and in those who take immediate-release levodopa (Sinemet). Only a small number of people have significant side effects that actually reduce their quality of life. Simply changing your medication to a slow-release or changing the dosage or both can remedy the side effects.



5. Levodopa contributes to disease progression and is toxic to our brain.

Levodopa has been shown to increase life expectancy in people with Parkinson's, not accelerate the disease. Levodopa has also been shown to improve quality of life for people with PD. So not only does it help you live longer, but it helps you life a more enjoyable life.




Still questioning whether Levodopa is right for you? Talk with your neurologist. Make sure you are clear about which symptoms impact your life the most and share any hesitations or fear around starting mediations.






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