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Changes in psychomotor effects of L-dopa and methylphenidate after sustained dopaminergic therapy in Parkinson disease
  1. Andrew H Evans (andrew.evans{at}mh.org.au)
  1. Department of Neurology, Royal Melbourne Hospital, Victoria, Australia
    1. Andrew D Lawrence (lawrencead{at}cardiff.ac.uk)
    1. Wales Institute of Cognitive Neuroscience, School of Psychology, Cardiff University, United Kingdom
      1. Andrew J Lees (alees{at}ion.ucl.ac.uk)
      1. The National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom

        Abstract

        Background: Sustained drug therapy in Parkinson disease may alter the psychomotor responses to acute challenges with dopaminergic drugs, L-dopa, and methylphenidate and cause cross-sensitisation.

        Methods: We assessed the mood, psychomotor, and reward-potentiating effects of an acute challenge with L-dopa and MPH on separate occasions under double-blind (medication-naïve) conditions after a placebo and then repeated the testing sessions in the same (medication-experienced) patients following a median period of 16.7 months continuous dopaminergic drug therapy.

        Results: In the medication-naïve condition affect was not changed by L-dopa or methylphenidate and only L-dopa improved motor function. In the medication-experienced condition, active drugs improved positive affect compared to the medication-naïve condition and there was an enhanced effect of L-dopa on motor function. Reward-responsivity was enhanced by both L-dopa and methylphenidate in medication-naïve and experienced condition.

        Conclusion: Sustained dopaminergic drug therapy augments the motor effects of an acute challenge with L-dopa and induces euphoriant effects to L-dopa and methylphenidate challenges.

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