PubMed · 7374623
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1980-06-13. Sinemet - 25/100.. https://pubmed.ncbi.nlm.nih.gov/7374623/
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We report 6 patients with pathological gambling during pharmacologic treatment for Parkinson disease (PD). Four patients were treated with levodopa/carbidopa and dopamine agonist (DA), and 2 patients received DA monotherapy. We reviewed several published reports regarding pathological gambling and antiparkinsonian therapy and suggest that more advanced PD and antiparkinsonian combination therapy (e.g., levodopa/carbidopa and DA) increases the risk for development of pathological gambling behavior compared with monotherapy with either DA or levodopa/carbidopa.
Pharmacotherapy designed to alleviate the symptoms of Parkinson's disease is focused on the stimulation of striatal dopamine receptors. The ideal pharmacological treatment would involve continuous dopaminergic stimulation. Currently, the most effective pharmacotherapy available is levodopa delivered orally; however, its short plasma half-life in combination with erratic gastric emptying and intestinal absorption makes dopaminergic stimulation pulsatile. Motor fluctuations and dyskinesias develop with time as a consequence and can become disabling. A gel formulation of levodopa/carbidopa has been developed for enteral (duodenal or jejunal) infusion via a portable pump. The infusion provides smooth plasma levodopa levels, more continuous dopaminergic stimulation and effective treatment of motor complications.
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