Risk factors for levodopa-induced dyskinesias in Parkinson's disease

J Neurol. 1999 Dec;246(12):1127-33. doi: 10.1007/s004150050530.

Abstract

To identify putative risk factors for levodopa-induced dyskinesias we studied the effect of several clinical variables on the occurrence of dyskinesias in a series of 168 consecutive patients with Parkinson's disease treated for at least 6 months with levodopa. Of these, 108 (64%) developed dyskinesias after a mean duration of levodopa treatment of 51.4 +/- 43.3 months. Patients tended to suffer dyskinesias on the side of the body first affected by Parkinson's disease. The overall probability of developing dyskinesias increased with levodopa treatment duration, about 10% per year during the first 7 years. Univariate and multivariate logistic regression analysis identified the age at onset of Parkinson's disease (OR 0.923; 95% CI 0.883-0.964) and the initial levodopa dose (mean dose of the first 6 months of treatment; OR 1.004; 95% CI 1.002-1.006) as the main independent predictors. Survival curves showed that onset of Parkinson's disease at age 50 years or before (logrank, P < 0.05) and initial levodopa treatment with more than 600 mg/day (logrank, P < 0.05) were associated with a higher risk for the appearance of dyskinesias.

MeSH terms

  • Age of Onset
  • Aged
  • Dose-Response Relationship, Drug
  • Dyskinesia, Drug-Induced* / physiopathology
  • Female
  • Humans
  • Levodopa / administration & dosage
  • Levodopa / adverse effects*
  • Levodopa / therapeutic use
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / epidemiology
  • Risk Factors
  • Survival Analysis
  • Time Factors

Substances

  • Levodopa