Weiner W J, Koller W C, Perlik S, Nausieda P A, Klawans H L
Neurology. 1980 Dec;30(12):1257-61. doi: 10.1212/wnl.30.12.1257.
Chronic treatment of parkinsonism with levodopa or levodopa/carbidopa is associated with problems that include dyskinesia, on-off phenomena, hallucinosis, and possible loss of therapeutic efficacy. We studied the effects of a period of transient drug withdrawal (drug holiday) in 16 patients who manifested these complications of chronic levodopa therapy. Patients were evaluated daily before, during, and after the period of drug withdrawal. Eleven of the 16 patients exhibited enhanced motor responsiveness after the holiday and required only half of the initial daily dose for improved motor performance. Most levodopa-induced side effects decreased after the holiday. Hallucinosis was ameliorated in all cases. The frequency of on-off phenomena and myoclonus also diminished. Sensitivity to levodopa-induced dyskinesia was not affected by the drug holiday. Because most patients required lower dosage after the holiday, dyskinesias were no longer present. These observations suggest that parkinsonian patients who suffer complications of chronic levodopa therapy may benefit from a period of drug withdrawal.
长期使用左旋多巴或左旋多巴/卡比多巴治疗帕金森病会引发一系列问题，包括运动障碍、开关现象、幻觉以及可能出现的治疗效果丧失。我们对16名出现慢性左旋多巴治疗并发症的患者进行了一段短暂停药期（药物假期）的效果研究。在停药期之前、期间和之后，每天对患者进行评估。16名患者中有11名在停药期后表现出运动反应增强，并且仅需初始每日剂量的一半就能改善运动表现。停药期后，大多数左旋多巴引起的副作用有所减轻。幻觉在所有病例中均得到改善。开关现象和肌阵挛的频率也有所降低。药物假期对左旋多巴诱发的运动障碍的敏感性没有影响。由于大多数患者在停药期后需要较低剂量，运动障碍不再出现。这些观察结果表明，患有慢性左旋多巴治疗并发症的帕金森病患者可能会从一段停药期中获益。
