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Acute overdosage and intoxication with carbidopa/levodopa can be detected in the subacute stage by measurement of 3-o-methyldopa
  1. Neurological Department, University Hospital Hamburg-Eppendorf, Hamburg, Germany
  1. Dr Hans Joerg Stuerenburg, Neurological Department, Universitètskrankenhaus Eppendorf Martinistrasse 52, 20246 Hamburg, Germany. Telephone 0049 40 4717 4832; fax 0049 40 4717 5086; email stuerenburg{at}

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Although the effects of a chronic overdosage with levodopa are well known, few cases of acute intoxication have been described.1 2 A particular problem in establishing a diagnosis of levodopa overdosage is the relatively short half life in the circulation of levodopa.3 4 If there is a delay in bringing an acutely intoxicated patient to hospital, perhaps due to late discovery, the blood concentration of levodopa could already be normal (corresponding to the peak levodopa concentration in Parkinson’s disease therapy) after 6–8 hours. Depending on the extent of the overdosage, the time could be even shorter. This report describes the clinical effects and the plasma concentrations of levodopa and specific metabolites over a period of 132.5 hours after ingestion of 30 tablets of carbidopa/levodopa (50 mg/200 mg tablets).

A 76 year old patient had a pre-existing mild akinetic rigid Parkinson’s syndrome, which had been treated for the past 1.5 years with 3×1 tablets of carbidopa/levodopa (50 mg/200 mg) a day without a substantial response. The weight of the patient was 74 kg. A known chronic obstructive airway disease was treated with a home oxygen appliance. At about 8.30 pm, the patient had …

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