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Donald J. Dalessio, MD
La Jolla, Calif

From the Department of Neurology, Scripps Clinic and Research Foundation, La Jolla, Calif.

Member, editorial board, The Journal.

JAMA. 1981;245(21):2200-2202.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

'Drug Holidays' and Parkinson's Disease

A major advance in neurological therapeutics has been achieved in the last decade, using a regimen of levodopa or a combination of levodopa and carbidopa in Parkinson's disease.^1,2 Almost all patients with Parkinson's disease will respond in some degree to these drugs. With time, however, usually in three to six years, the effects of long-term levodopa therapy may become blunted.^2-4 Furthermore, the incidence of levodopa-induced side effects progressively increases. For example, after five years, 40% to 80% of patients with Parkinson's disease taking these medications will demonstrate dyskinesias.⁵ Alterations in motor skills become common. Sudden changes from dyskinesias to akinesia (the on-off phenomenon) are well described.⁶ Psychiatric symptoms of a toxic confusional type may occur, especially in the elderly.⁷ Myoclonus and dystonias have been reported as well.^8,9 It is suggested that these side effects are related to alterations in . . . [Full Text PDF of this Article]

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