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NEUROLOGY 1988;38:533
© 1988 American Academy of Neurology

Clinical significance of the relationship between O-methyldopa levels and levodopa intake

Jesse M. Cedarbaum, MD, Henn Kutt, MD and Fletcher H. McDowell, MD

From the Department of Neurology, Burke Rehabilitation Center and Cornell University Medical College, White Plains, NY.

A recent clinical trial of controlled-release carbidopa/levodopa preparation afforded us the opportunity to examine the effects of chronically increasing circulating 3-O-methyldopa (OMD) levels on the clinical response to levodopa. In patients taking standard Sinemet, both mean plasma OMD levels and the area under the plasma concentration- versus-time curve (AUC) obtained during 8-hour periods of blood sampling correlated highly with the total daily intake of levodopa. In patients taking the controlled-release formulation, the mean daily intake of levodopa was doubled. This, in turn, led to a doubling of the mean OMD level and its AUC, whereas the AUC for levodopa was unchanged. Despite the increase in circulating OMD there was no reduction in mobility in either the "on" or "off" conditions. Thus, doubling plasma OMD levels did not seem to interfere with brain uptake of levodopa sufficiently to cause a deterioration in its therapeutic efficacy in these patients.

Address correspondence and reprint requests to Dr. Cedarbaum, The Burke Rehabilitation Center, 785 Mamaroneck Avenue, White Plains, NY 10605.

Supported in part by the Winifred Masterson Burke Relief Foundation, the G. Harold and Leila Y. Mathers Charitable Foundation, The Shirley Winkler Parkinson's Research Fund, grant RR0047 from the Division of Research Resources, NIH, and Merck, Sharp & Dohme, Inc.

Received May 21, 1987. Accepted for publication in final form July 23, 1987.






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