Abstract

To the Editor: In their article on effects of suprathreshold levodopa on dyskinesia in advanced Parkinson's disease (PD), Verhagen Metman et al. show that increasing the dose of levodopa will steeply increase both the antiparkinsonian and dyskinetic response until plateau levels are reached.1 Further increase of levodopa dose does not aggravate the severity of dyskinesia, but the antiparkinsonian response duration increases. This implies that in fluctuating patients with disabling end-of-dose parkinsonism, it may be better to bring about improvement by increasing individual levodopa doses rather than fractionating the levodopa doses. This conclusion, however, appears to …

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