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Departments of Neurology (Drs. Nutt and Woodward), Pharmacology (Dr. Nutt), and Biochemistry (Dr. Woodward), Oregon Health Sciences University, Portland, OR.
We investigated levodopa intravenous infusion rates, plasma concentrations, and clinical responses in 23 parkinsonian patients with a fluctuating response to the drug. There was a linear relationship between rate of levodopa infusion and plasma concentration when carbidopa was coadministered. Minimum-therapeutically effective plasma concentrations of levodopa ranged from 3 to 12 nmol/ml. The duration, but not the magnitude, of clinical response was linearly related to plasma concentrations. The clinical response lagged behind the rise and fall of plasma levodopa. There was no evidence of idiosyncratic pharmacokinetic or pharmacodynamic responses to levodopa to explain the fluctuating response.
Address correspondence and reprint requests to Dr. Nutt, Department of Neurology, Oregon Health Sciences University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97201.
Supported in part by the United Parkinson Foundation, NINCDS 1 RO1 NS 21062–01, Clinical Research Centers Grant RR00334, and BRSG S07 RR05412.
Accepted for publication October 14, 1985.
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