title: Acute vs chronic effects of l-dopa on bladder function in patients with mild Parkinson disease.
abstract: OBJECTIVE
  To compare acute and chronic effects of l-dopa on bladder function in levodopa-naive Parkinson disease (PD) patients who had urinary urgency.
  
  
  METHODS
  We evaluated 26 l-dopa-naive PD patients at a university-based PD center with a first urodynamic session with a double examination: in the off treatment condition and 1 hour after acute challenge with carbidopa/l-dopa 50/200 mg; then, a chronic l-dopa monotherapy was administered (mean dose 300 +/- 150 mg). Two months later, patients underwent a second urodynamic session with a single evaluation 1 hour after the acute carbidopa/l-dopa challenge.
  
  
  RESULTS
  The first acute l-dopa challenge significantly worsened bladder overactivity (neurogenic overactive detrusor contractions threshold [NDOC-t; 32% of worsening] and bladder capacity [BC; 22% of worsening]); on the contrary, l-dopa challenge during chronic administration ameliorated the first sensation of bladder filling (FS; 120% of improvement), NDOCT-t (93% improvement), and BC (33% of improvement) vs the values obtained with acute administration. An 86% significant improvement of FS in comparison with the basal value was observed.
  
  
  CONCLUSIONS
  The acute and chronic l-dopa effects may be due to the different synaptic concentrations or to the activation of postsynaptic mechanisms obtained by chronic administration.
authors.affiliation: Clinica Neurologica, Università Tor Vergata Roma, Roma, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Brusa
authors.forename: F
authors.initials: F
authors.lastname: Petta
authors.forename: A
authors.initials: A
authors.lastname: Pisani
authors.forename: V
authors.initials: V
authors.lastname: Moschella
authors.forename: C
authors.initials: C
authors.lastname: Iani
authors.forename: P
authors.initials: P
authors.lastname: Stanzione
authors.forename: R
authors.initials: R
authors.lastname: Miano
authors.forename: E
authors.initials: E
authors.lastname: Finazzi-Agrò
mesh_terms: D000208:Acute Disease / Q000628:therapy; D002230:Carbidopa / Q000008:administration & dosage / Q000009:adverse effects; D002908:Chronic Disease / Q000628:therapy; D015259:Dopamine Agents / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007001:Hypogastric Plexus / Q000187:drug effects / Q000503:physiopathology; D007980:Levodopa / Q000008:administration & dosage* / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D017777:Parasympathetic Fibers, Postganglionic / Q000187:drug effects / Q000503:physiopathology; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D009435:Synaptic Transmission / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000187:drug effects / Q000294:innervation / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000139:chemically induced* / Q000188:drug therapy* / Q000503:physiopathology; D014555:Urination Disorders / Q000139:chemically induced / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D015259:Dopamine Agents; D007980:Levodopa; D002230:Carbidopa