Kaitlyn Grubbs

Miss Thomson
AP English Language & Composition
31 January 2018
Levodopa: Parkinson’s Miracle Drug

Parkinson’s disease is a complex disorder which is fairly common with approximately

200,000 cases per year in the United States alone (“Parkinson's Disease”). Although it has a late-

onset, it can affect anyone at any age. The disorder is so powerful that it has the ability to flip

someone’s life upside down without proper treatment. In the early 1900’s a drug by the name of

levodopa (L-Dopa) was discovered to be promising in treating Parkinson’s. L-dopa is the miracle

drug that has been sought after for parkinsonian patients that has changed the medical world

forever.

Individuals suffering from Parkinson’s can be commonly identified by the typical

symptoms including: tremor, rigidity, bradykinesia (slowness of movement), and postural

instability, although tremor is the most widely known (Pereira, Erlick A C, and Tipu Z Aziz).

These symptoms can often be overlooked as they can be a result of normal aging. In 1817, James

Parkinson, whom the disease was named after, documents that he was suffering from “the shaky

palsy” and later began his own research in regards to his condition (Parkinson's Disease:

Unraveling the Mystery). To diagnose a patient with Parkinson’s, a doctor may rely on the

individual’s medical history and a neurological examination. However, chromosome 6 contains a

“Parkin” gene which is responsible for destroying proteins that no longer function properly and

codes for a “Parkin” protein which aids in the destruction by tagging cells that need to be

destroyed. When these malfunctioning cells are not broken down, they may oxidize into toxic

free radicals (Parkinson's Disease: Unraveling the Mystery). These free radicals would cause
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damage to the metabolites of dopamine, commonly known as the “feel good” neurotransmitter

(Foster, H D, and A Hoffer), which has proved to be necessary in explaining why patients with

Parkinson’s have been found to have unnaturally low levels of dopamine in the brain (“L-

Dopa”). This error caused by the malfunctioning “Parkin” gene is problematic, but it is not

entirely irreversible.

To combat the error caused by the “Parkin” gene, scientists researched and discovered L-

Dopa’s potential to revolutionize treatment. Before such information was discovered, a doctor by

the name of Arvid Carlsson developed a sensitive fluorescent technique to measure low

dopamine levels through lack of pigmentation in the brain and later discovered dopamine’s role

in motor function. Utilizing this information, George C. Cotzias used the technique in order to

restore the pigmentation in patients using three different drugs, one being L-dopa, which was

dramatically successful in reversing the symptoms of Parkinson’s. After seeing videos of

Cotzias’s patients, Melvin D. Yahr performed a double-blind controlled clinical trial using the

drug – meaning that neither the patient nor the administrator were aware of which patients

received the real drug or the placebo, thus eliminating biased results (Lees, A J). It was later

discovered that

L-DOPA (the precursor to dopamine) is metabolized into dopamine in the body by an

enzyme called aromatic L-amino acid decarboxylase (AADC). Dopamine itself cannot
pass through the protective blood-brain barrier, but L-DOPA can. When L-DOPA is
administered orally, a small percentage passes into the brain and is converted into
dopamine. This temporary increase in dopamine levels within the brain offers relief of
Parkinson's disease symptoms for a short period. (Lifeextension.com)
This procedure was not completely successful and requires the dopamine to be metabolized in

the central nervous system, making it necessary to be administered with an inhibitor. The

inhibitor, typically Carbidopa, preserves L-dopa from converting into dopamine before it gets to
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the brain (Lifeextension.com). Alongside an inhibitor, L-Dopa is able to effectively get past the

blood-brain barrier to convert into dopamine and aid in treating Parkinson’s disease.

L-Dopa calms the symptoms of Parkinson’s disease, however it is not a cure. Varying

from patient to patient, the dosage varies in order to provide the same relief of symptoms as it

did before. Adverse side effects are present, stemming from the use of the drug, but some will

only become apparent years after treatment has begun. Some effects include: arrhythmia

(irregular heartbeat), gastrointestinal discomfort, hair loss, confusion, extreme emotional

variability (mood swings) with anxiety, vivid dreams, hallucinations, impaired social behavior,

sleepiness, excessive libido, and compulsive behavior. A very common effect is dyskinesia, or a

movement disorder in which the individual has involuntary movements and discoordination. This

discoordination may also affect the autonomic nervous system, comprised of the Sympathetic

Nervous System and Parasympathetic Nervous System, which may result in respiratory

irregularities (Lifeextension.com). Scientists are aware that the adverse effects are a consequence

of neurons becoming more sensitive to the drug by changing a patient’s gene activity, but a

precise explanation for this is missing (Kegel, Magdalena). However, the provided relief of even

the most pronounced rigidity, tremor, and bradykinesia led to its regulatory approval by the FDA

(Lees, A J, et al). Using L-Dopa to treat Parkinson’s disease has opened the doors to further

research.

Since the research performed in regards to L-Dopa has led to advances in knowledge of

neurotransmitters, modern-day scientists have acquired a better understanding of them which has

opened the door to various medical research. Dr. Oscar Kofman, who studied treatments of

Parkinson’s, stated that

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Our experience in the use of L-dopa in 83 patients who have been treated during the past
22 months is presented to provide a practical approach to the administration of L-dopa.
Many parkinsonian patients can be treated advantageously on an outpatient basis without
the need for initial hospitalization. (Kofman, Oscar)
As the research of Parkinson’s extended past just the basic treatment, treatment has been

improved and the cost of the medication has decreased to a fraction of its original cost. In 1997

and with further research, The Food and Drug Administration approved of other drugs such as

Mirapex, Requip, and Tasmar to be used with L-dopa to help to improve symptoms while

lessening the required dosage of L-dopa (“L-Dopa”). These advancements have aided in

improving the treatment of Parkinson’s disease exponentially.

The discovery of L-dopa’s ability to treat Parkinson’s disease was a pivotal moment in

medicine, as the research regarding it was a gateway into research on neurotransmitters. Through

the clinical trials and research of Arvid Carlsson, George C. Cotzias, and Melvin D. Yahr, and,

despite some adverse side effects, L-dopa was the first drug discovered to treat parkinsonian

patients. Modern medicine has taken this information further and made treatments more effective

and able to conform to a patient’s needs and provide a somewhat lasting relief to the various

symptoms of Parkinson’s disease. This sought after solution to a rather complex disorder has

changed the medical world forever as it demonstrates that researchers are able to break through

barriers and solve problems that seem otherwise impossible to conquer.

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Works Cited

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“Parkinson's Disease.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 7
July 2015, www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-
causes/syc-20376055. Accessed 6 Jan. 2018. Web.
“Parkinson's Disease: Diagnosis and Treatment.” NIH MedlinePlus the Magazine,
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Foster, H D, and A Hoffer. “The Two Faces of L-DOPA: Benefits and Adverse Side Effects in
the Treatment of Encephalitis Lethargica, Parkinson's Disease, Multiple Sclerosis and
Amyotrophic Lateral Sclerosis.” Medical Hypotheses., U.S. National Library of
Medicine, www.ncbi.nlm.nih.gov/pubmed/14962622. Accessed 6 Jan. 2018. Web.

Kegel, Magdalena. “Researchers Discover Why L-DOPA Stops Working in Parkinson's

Patients.” Parkinson's News Today, 4 Aug. 2016,
parkinsonsnewstoday.com/2016/08/04/researchers-discover-why-l-dopa-stop-working-
parkinsons-seeking-prolonged-treatment/. Accessed 6 Jan. 2018. Web.

Kofman, Oscar. “Treatment of Parkinson's Disease with L-Dopa: A Current Appraisal.”

Canadian Medical Association Journal, U.S. National Library of Medicine, 20 Mar.
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Lees, A J, et al. “Four Pioneers of L-Dopa Treatment: Arvid Carlsson, Oleh Hornykiewicz,
George Cotzias, and Melvin Yahr.” Movement Disorders: Official Journal of the
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serendip.brynmawr.edu/bb/neuro/neuro01/web2/Farrenkopf.html. Accessed 6 Jan. 2018.
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Pereira, Erlick A C, and Tipu Z Aziz. “Surgical Insights into Parkinson's Disease.” Journal of the
Royal Society of Medicine, The Royal Society of Medicine, May 2006,
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