Neurological Sciences

, Volume 29, Supplement 5, pp 387–388 | Cite as

Continuous dopaminergic stimulation achieved by duodenal levodopa infusion



Continuous dopaminergic stimulation is the ideal approach for the management of Parkinson’s disease (PD); this goal can be partially reached with dopamine agonists, but the need for a therapeutic strategy providing a strong and constant dopaminergic stimulation also in the advanced phase of the disease remains unmet. The application of levodopa/carbidopa-gel suspension directly in the duodenum (Duodopa) allows a continuous delivery by a portable pump, resulting in smoother levodopa plasmatic concentrations, and consequently in a physiologic continuous receptor stimulation. Clinical studies have demonstrated that duodenal infusion was associated with significantly better outcome compared to conventional treatment regarding global functioning, ability to walk, “off” time and motor fluctuations. A retrospective analysis of the long-term clinical experience with Duodopa evidenced that daily dose of levodopa decreased by 5% during follow-up. The profile of pharmacological adverse events of Duodopa was similar to that observed with oral administration; dislocation of the intestinal tube to the stomach was the most common technical problem.


Continuous dopaminergic stimulation Dopamine agonists Duodenal levodopa infusion 


  1. 1.
    Antonini A (2007) Continuous dopaminergic stimulation — from theory to clinical practice. Parkinsonism Relat Disord 13[Suppl]:S24–S28PubMedCrossRefGoogle Scholar
  2. 2.
    Nyholm D, Askmark H, Gomes-Trolin C (2003) Optimizing levodopa pharmacokinetics: intestinal infusion versus oral sustained-release tablets. Clin Neuropharmacol 26:156–163PubMedCrossRefGoogle Scholar
  3. 3.
    Nyholm D, Nilsson Remahl AI, Dizdar N et al (2005) Duodenal levodopa infusion monotherapy vs oral polypharmacy in advanced Parkinson’s disease. Neurology 64:216–223PubMedGoogle Scholar
  4. 4.
    Nyholm D, Lewander T, Johansson A et al (2008) Enteral levodopa/carbidopa infusion in advanced Parkinson disease: long term exposure. Clin Neuropharmacol 31:63–73PubMedCrossRefGoogle Scholar
  5. 5.
    Eggert K, Schrader C, Hahn M et al (2007) Continuous jejunal levodopa infusion in patients with advanced Parkinson’s disease: practical aspects and outcome of motor and non-motor complications. Clin Neuropharmacol 31:151–166CrossRefGoogle Scholar
  6. 6.
    Antonini A, Isaias IU, Canesi M et al (2007) Duodenal levodopa infusion for advanced Parkinson’s disease: 12-month treatment outcome. Mov Disord 22:1145–1149PubMedCrossRefGoogle Scholar
  7. 7.
    Antonini A, Mancini F, Canesi M et al (2008) Duodenal levodopa infusion improves quality of life in advanced Parkinson’s disease. Neurodegener Dis 5:244–246PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  1. 1.Department of NeurologyCentral HospitalBremerhavenGermany
  2. 2.Graduate School for Neurosciences Amsterdam Department of NeurologyAcademisch Ziekenhuis Vrije UniversiteitAmsterdamThe Netherlands
  3. 3.Parkinson InstituteIstituti Clinici di PerfezionamentoMilanItaly

Personalised recommendations