Evaluation of chronic levodopa therapy in Parkinson's disease

Levodopa is the most useful drug for treatment of Parkinson's disease today, even if a progressive decline of therapeutic activity with the appearance of important side affects is a well known feature of the long-term levodopa therapy. Here we report our 15 year experience on uninterrupted treatment with levodopa. Among parkinsonian patients two groups of parkinsonian patients can be distinguished, one of them is dopa-sensitive and the other one is dopa-insensitive. The direct dopaminergic agents showed to be effective in the treatment of Parkinson's disease, particularly in the treatment of patients who are no longer satisfactorily responding to levodopa. We suggest to keep the dose of levodopa low, using the minimal effective dosage, for an optimal long-term management.