Abstract
Background. It is known that ultra-low doses of haloperidol can cause dopamine supersensitivity of dopamine D2 receptors and related behaviour in animals. Objective. The objective was to determine whether a daily ultra-low dose of 40 micrograms of haloperidol could enhance the clinical action of levodopa in Parkinson's disease patients. Method. While continuing their daily treatment with levodopa, 16 patients with Parkinson's disease were followed weekly for six weeks. They received an add-on daily dose of 40 micrograms of haloperidol for the first two weeks only. The SPES/SCOPA scale (short scale for assessment of motor impairments and disabilities in Parkinson's disease) was administered before treatment and weekly throughout the trial. Results. The results showed a mean decrease in SPES/SCOPA scores after one week of the add-on treatment. Conclusion. SCOPA scores decreased after the addition of low-dose haloperidol to the standard daily levodopa dose. This finding is consistent with an increase in sensitivity of dopamine D2 receptors induced by haloperidol. Such treatment for Parkinson's disease may possibly permit the levodopa dose to be reduced and, thus, delay the onset of levodopa side effects.
Highlights
While levodopa is the mainstay treatment of Parkinson disease, long-term use of levodopa has many side effects [1].It is desirable, to find new ways of enhancing the clinical efficacy of levodopa so as to delay its progressive dose increase over the duration of treatment.A possible method of enhancing the action of dopaminergic therapy is to increase the sensitivity of dopamine D2 receptors that are the main targets for dopamine agonists [2]
The present study examined whether an ultra-low daily dose of 40 micrograms of haloperidol could enhance the action of the patient’s daily dose of levodopa
At the start of the study, each subject was informed of the title of the study, that the study had been approved by the Therapeutic Products Program at Health Canada in Ottawa, the name of the drug that would be added to their present medication, the dose of the medication, that the low dose of the added drug was far lower than is normally used for other clinical indications and was not expected to cause any muscle stiffness or related motor effects, and that the subject was free to stop taking the medication at any time
Summary
It is known that ultra-low doses of haloperidol can cause dopamine supersensitivity of dopamine D2 receptors and related behaviour in animals. The objective was to determine whether a daily ultra-low dose of 40 micrograms of haloperidol could enhance the clinical action of levodopa in Parkinson’s disease patients. While continuing their daily treatment with levodopa, 16 patients with Parkinson’s disease were followed weekly for six weeks. They received an add-on daily dose of 40 micrograms of haloperidol for the first two weeks only. SCOPA scores decreased after the addition of low-dose haloperidol to the standard daily levodopa dose. This finding is consistent with an increase in sensitivity of dopamine D2 receptors induced by haloperidol. Such treatment for Parkinson’s disease may possibly permit the levodopa dose to be reduced and, delay the onset of levodopa side effects
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