Neuropsychiatric Adverse Events Associated With Foslevodopa/Foscarbidopa Continuous Subcutaneous Infusion in Clinical
David Campo-Caballero1,2,3,4, Jon Rodriguez-Antiguedad4,5,6,7, Arnau Puig-Davi4,5,6,7
1Department of Neurology, Movement Disorders Unit, Hospital Universitario Donostia, San Sebastián, Spain.
European Journal of Neurology
|July 6, 2026
Summary
Foslevodopa/foscarbidopa continuous subcutaneous infusion (LDp/CDp CSI) can cause neuropsychiatric adverse events (AEs) in Parkinson's disease patients. Most AEs were mild-to-moderate and rarely led to treatment discontinuation.
Area of Science:
- Neurology
- Pharmacology
Background:
- Foslevodopa/foscarbidopa continuous subcutaneous infusion (LDp/CDp CSI) is effective for advanced Parkinson's disease (PD).
- Neuropsychiatric adverse events (AEs) have been reported with LDp/CDp CSI, with potential links to prior hallucinations or cognitive impairment.
Purpose of the Study:
- To determine the incidence and risk factors of neuropsychiatric AEs in a large, prospective, real-world cohort of PD patients treated with LDp/CDp CSI.
Main Methods:
- Analysis of data from the DATs-PD GETM Spanish Registry, an observational, prospective, multicenter, open-label study.
- Inclusion of 214 patients treated with LDp/CDp CSI, with assessment of baseline characteristics and follow-up for neuropsychiatric AEs.
Main Results:
- 19.2% of patients developed at least one neuropsychiatric AE during follow-up (median 163 days), mostly mild-to-moderate.
- Baseline impulse control disorders (ICDs) were associated with an increased risk of ICD-related AEs.
- No significant association was found between baseline cognitive impairment or psychotic features and the development of hallucinations/psychosis/confusion.
Conclusions:
- Neuropsychiatric AEs, primarily hallucinations/psychosis, occur in a relevant proportion of patients on LDp/CDp CSI but are generally mild and rarely lead to discontinuation.
- Baseline cognitive and psychotic features, apart from ICDs, did not increase the incidence of these AEs.
- LDp/CDp CSI can be used in appropriately selected patients with careful clinical monitoring.
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