Non-subtype-selective opioid receptor antagonism in treatment of levodopa-induced motor complications in Parkinson's disease

Authors

  • Susan Fox MCRP, PhD,

    Corresponding author
    1. The Walton Centre for Neurology and Neurosurgery, Liverpool, United Kingdom
    • Movement Disorders Clinic, Toronto Western Hospital, 399 Bathurst St., MP11, Toronto, ON, Canada M5T-2S8
    Search for more papers by this author
  • Montague Silverdale MRCP,

    1. The Walton Centre for Neurology and Neurosurgery, Liverpool, United Kingdom
    Current affiliation:
    1. Department of Neurology, Hope Hospital, Salford, United Kingdom
    Search for more papers by this author
  • Mark Kellett MCRP, MD,

    1. The Walton Centre for Neurology and Neurosurgery, Liverpool, United Kingdom
    Current affiliation:
    1. Department of Neurology, Hope Hospital, Salford, United Kingdom
    Search for more papers by this author
  • Rhys Davies MRCP,

    1. The Walton Centre for Neurology and Neurosurgery, Liverpool, United Kingdom
    Current affiliation:
    1. University Neurology Unit, Addenbrooke's Hospital, Cambridge, United Kingdom
    Search for more papers by this author
  • Malcolm Steiger FRCP, MD,

    1. The Walton Centre for Neurology and Neurosurgery, Liverpool, United Kingdom
    Search for more papers by this author
  • Nicholas Fletcher FRCP, MD,

    1. The Walton Centre for Neurology and Neurosurgery, Liverpool, United Kingdom
    Search for more papers by this author
  • Alan Crossman DSc,

    1. Manchester Movement Disorders Laboratory, University of Manchester, Manchester, United Kingdom
    Search for more papers by this author
  • Jonathan Brotchie PhD

    1. The Walton Centre for Neurology and Neurosurgery, Liverpool, United Kingdom
    Current affiliation:
    1. Toronto Western Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
    Search for more papers by this author

Abstract

Opioid peptide transmission is enhanced in the striatum of animal models and Parkinson's disease (PD) patients with levodopa-induced motor complications. Opioid receptor antagonists reduce levodopa-induced dyskinesia in primate models of PD; however, clinical trials to date have been inconclusive. A double-blind, placebo controlled, crossover design study in 14 patients with PD experiencing motor fluctuations was carried out, using the non-subtype-selective opioid receptor antagonist naloxone. Naloxone did not reduce levodopa-induced dyskinesia. The duration of action of levodopa was increased significantly by 17.5%. Non-subtype-selective opioid receptor antagonism may prove useful in the treatment of levodopa-related wearing-off in PD but not in dyskinesia. © 2003 Movement Disorder Society

Ancillary