In seven patients with Parkinson's disease with daily motor fluctuations, we found that the same subcutaneous apomorphine dose that improved motor function when given in the morning after a normal night without taking levodopa failed to turn patients on during afternoon and evening off periods, and on a different morning after receiving levodopa during the night.
No significant changes in levodopa or 3-O-methyldopa plasma levels that could explain these variations were detected. These findings suggest that increased daily levodopa consumption may reduce striatal responsiveness to dopaminergic stimulation.
CITATION Clin Neuropharmacol. 1989 Aug;12(4):271-84
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