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Carbidopa-levodopa overdose.

K A Sporer1

  • 1Section of Emergency Medicine, Louisiana State University School of Medicine, New Orleans 70112.

The American Journal of Emergency Medicine
|January 1, 1991
PubMed
Summary
This summary is machine-generated.

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A woman experienced persistent choreiform movements after ingesting a large dose of carbidopa-levodopa and other medications. Paralysis with pancuronium was required for 60 hours to resolve the involuntary movements.

Area of Science:

  • Neuroscience
  • Clinical Pharmacology

Background:

  • Carbidopa-levodopa is a common treatment for Parkinson's disease.
  • Adverse drug reactions can occur with overdose or polypharmacy.

Observation:

  • A patient presented with choreiform movements after ingesting 15-17 tablets of carbidopa-levodopa (150 mg carbidopa, 1,500 mg levodopa) and other analgesics/muscle relaxants.
  • The choreiform movements were intractable to naloxone, morphine, and diazepam.
  • The patient developed elevated creatine phosphokinase and myoglobinuria, indicative of muscle breakdown.

Findings:

  • Severe carbidopa-levodopa overdose can induce persistent choreiform movements.
  • Muscle damage (rhabdomyolysis) can occur secondary to severe levodopa toxicity.
  • Neuromuscular blockade with pancuronium was effective in resolving the chorea.

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Implications:

  • This case highlights the potential for severe, persistent movement disorders with carbidopa-levodopa overdose.
  • It underscores the importance of monitoring for rhabdomyolysis in such cases.
  • Neuromuscular blockade may be a necessary intervention for intractable chorea in overdose scenarios.