Is L‐DOPA drug holiday useful?

Abstract

We studied nine patients with severe, chronic Parkinson disease and complications of long-term L-DOPA therapy. After a “holiday” of 3 to 21 days, excess dopamine effects improved in all patients, and the baseline parkinsonian picture emerged. After reinstitution of L-DOPA therapy, often at lower doses than had been used previously, parkinsonian signs improved. Complications of immobility were seen in two patients; one had deep vein thrombophlebitis, and the other became depressed. In treating the individual patient, the risks of immobility despite aggressive attempts to prevent complications should be weighed against the possible improvement of parkinsonism. These findings suggest that a holiday from L-DOPA therapy may extend the drug's usefulness in treating Parkinson disease, perhaps by resensitizing striatal dopamine receptors in patients receiving the drug for prolonged periods.