Methylphenidate Increases the Motor Effects of L-Dopa in Parkinson's Disease: A Pilot Study
作者:
Richard Camicioli,
Eric Lea,
John Nutt,
Gary Sexton,
Barry Oken,
期刊:
Clinical Neuropharmacology
(OVID Available online 2001)
卷期:
Volume 24,
issue 4
页码: 208-213
ISSN:0362-5664
年代: 2001
出版商: OVID
关键词: Parkinson's disease;L-Dopa;Methylphendidate;Dopamine transporter;Pharmacodynamics
数据来源: OVID
摘要:
We determined whether methylphenidate, a dopamine transporter blocker, modifies motor, cognitive, or affective responses to L-Dopa in Parkinson's disease (PD). Five patients who reported benefit from L-Dopa/carbidopa and motor fluctuations were admitted and withdrawn from their usual antiparkinsonian medications. On 3 consecutive days in a randomized double-blinded fashion, they took 0.2 mg/kg oral methylphenidate or placebo followed 30 minutes later by a 1-hour intravenous L-Dopa (2 mg/kg per h) or placebo infusion. Vital signs, tapping, walking, dyskinesias, mood, anxiety, concentration, and arousal were monitored every 30 minutes. Cognitive testing was performed before and following the infusion. Methylphenidate combined with L-Dopa led to greater peak right-hand tapping speed than either alone. Dyskinesia severity increased most when methylphenidate and L-Dopa were co-administered. There were no differences between conditions on the Stroop test, digit ordering, simple reaction time, or covert orienting of attention validity effect. Methylphenidate alone led to improvement in choice reaction time. Change in self-assessed analogue ratings of mood, anxiety, arousal, or concentration did not differ between conditions. Methylphenidate increased the motor effects of L-Dopa with minimal effects on cognitive or affective functions, suggesting a physiologic role for the dopamine transporter in patients with PD with motor fluctuations.
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