L-Dopa (levodopa) is a drug used in combination with carbidopa to treat Parkinson’s disease, typically prescribed under the brand name Sinemet. This article goes over the safety and potential short- and long-term side effects of L-Dopa, Sinemet, and other carbidopa-levodopa combinations. <\/p>\n\n\n
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Disclaimer<\/em><\/strong>: Levodopa is prescribed, usually in combination with carbidopa, to treat Parkinson\u2019s disease. This post provides a summary of the information on its side effects available in the scientific and clinical literature.<\/em> Please discuss your medications, dietary supplements, and any potential side effects you are experiencing with your healthcare provider. <\/em><\/p>\n\n\n\n L-DOPA has been the prime treatment for Parkinson\u2019s disease<\/strong> since the 1960s. It increases dopamine<\/a> levels in the brain, which provides relief of Parkinson\u2019s symptoms [R<\/a>]. <\/p>\n\n\n\n L-DOPA is administered with carbidopa (also known as SINEMET) for the treatment of Parkinson’s disease. The combination is classified by the FDA as a drug and is available only with a doctor’s prescription.<\/strong><\/p>\n\n\n\n L-DOPA supplements have not been approved by the FDA for medical use. Supplements generally lack solid clinical research. Regulations set manufacturing standards for them but don’t guarantee that they’re safe or effective. Speak with your doctor before supplementing. <\/p>\n\n\n\n In this article, we’ll go over:<\/p>\n\n\n\n The significant body of research on treatments shows that levodopa is generally safe and well-tolerated. Relevant side effects that have been reported with L-DOPA, Sinemet, and various levodopa-carbidopa combinations include the following:<\/p>\n\n\n\n Life-threatening side effects like Neuroleptic Malignant Syndrome (NMS) are rare but possible [R<\/a>]. <\/p>\n\n\n\n NMS is characterized by fever, high body temperature, altered consciousness, involuntary muscle twitches, and other neurological changes. It has mostly been reported with Sinemet withdrawal or dose reductions [R<\/a>]. <\/p>\n\n\n\n L-DOPA treatment in Parkinson\u2019s disease may increase risk-taking behavior and cause impulse control disorders, which include compulsive eating, pathological gambling, hypersexuality, and compulsive buying [R<\/a>].<\/p>\n\n\n\n These are observed in later stages of the disease, in which dopaminergic medication leads to abnormal dopamine peaks and hyperstimulation of specific brain mechanisms (mesolimbic system) [R<\/a>].<\/p>\n\n\n\n L-DOPA treatment has also been associated with an increased risk of <\/strong>osteoporosis and bone fracture in patients with Parkinson\u2019s disease<\/strong> due to the L-DOPA-induced exaggerated blood levels of the amino acid homocysteine<\/a> (hyperhomocysteinemia). This was reported in a study with 95 patients aged 55 years or older and in another study with 54 patients, which showed decreased bone mineral density in the spine and hip [R<\/a>, R<\/a>].<\/p>\n\n\n\n High homocysteine is also a risk factor for heart disease, cerebrovascular disease, and dementia [R<\/a>, R<\/a>, R<\/a>].<\/p>\n\n\n\n Long-term treatment with L-DOPA frequently causes <\/strong>abnormal muscle movements in Parkinson\u2019s disease patients<\/strong>. Dyskinesia is normally caused by the depletion of dopaminergic neurons that occurs in Parkinson\u2019s and with age. This has been attributed to both a direct effect in the basal ganglia<\/a> and excessive release of L-DOPA-derived dopamine in the striatum, a critical brain area in the control of movement [R<\/a>].<\/p>\n\n\n\n At the molecular level, L-DOPA leads to dyskinesia through the activation of dopamine D1 receptors, which results in the production of dynorphin-B, an opioid peptide [R<\/a>].<\/p>\n\n\n\n A possible role of serotonin receptors has also been proposed after findings in both rat and macaque models of Parkinson\u2019s [R<\/a>].<\/p>\n\n\n\n Increased aggression (hostility, impulsiveness) was reported in 1 out of 10 schizophrenic patients [R<\/a>].<\/p>\n\n\nL-DOPA & Sinemet Safety Overview<\/span><\/h2>\n\n\n\n
Side Effects<\/strong> of L-DOPA, Sinemet & Levodopa-Carbidopa Combinations<\/strong><\/span><\/h2>\n\n\n\n
Summary<\/span><\/h3>\n\n\n\n
Rare Side Effects<\/span><\/h3>\n\n\n\n
Possible Long-Term Side Effects<\/span><\/h3>\n\n\n\n
1) Impulsive and Risk-Taking Behavior<\/strong><\/h4>\n\n\n\n
2) Lower Bone Density<\/strong><\/h4>\n\n\n\n