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l dopa making symptoms worse


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#1 Skiing

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Posted 27 January 2017 - 12:07 AM

I have been diagnosed 4 years ago. Ldopa has no positive effect on my pd symptoms. So i had a l dopa challenge again. Not only did my symptoms not improve but they actually got worse particularly my rigor and pain. Mds told me he has never seen such a reaction and is at a loss. My solution so far has been to go without medication. Unsure what to do now? Thanks.

#2 Dr. Okun

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Posted 28 January 2017 - 01:23 PM

I usually get a GI emptying study and recommend a second opinion to see if this is actually PD or a look a like.  It could also be that the medications are not absorbing and the GI emptying study and sometimes apomorphine injections can be helpful.


Michael S. Okun, M.D.

Author of Amazon Kindle, Paperback and Audio of 10 Breakthrough Therapies for Parkinson's Disease
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips


#3 Skiing

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Posted 28 January 2017 - 03:34 PM

Thanks. Would absorption problems also intere with the soluble ldooa challenge test? It seems to me that it does get absorbed since stiffness and pain increase considerable with ldopa

#4 Skiing

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Posted 28 January 2017 - 03:36 PM

No one seems to be questioning the pd diagnosis. All they said was that i would long be in a wheelchair if it were atypical pd

#5 Dr. Okun

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Posted 04 February 2017 - 05:53 PM

Absorption can in some cases interfere with a dopamine challenge test; in these cases I use injectable apomorphine to look for a response.  Not everyone reaches a wheelchair and I try not to generalize too much though atypical parkinsonisms are usually more severe and harder to treat,


Michael S. Okun, M.D.

Author of Amazon Kindle, Paperback and Audio of 10 Breakthrough Therapies for Parkinson's Disease
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips





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