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Changes in psychomotor effects of L-dopa and methylphenidate after sustained dopaminergic therapy in Parkinson’s disease
  1. A H Evans1,2,3,
  2. A D Lawrence4,
  3. A J Lees3
  1. 1
    Department of Neurology, The Royal Melbourne Hospital, Victoria, Australia
  2. 2
    Department of Medicine, University of Melbourne, Australia
  3. 3
    Reta Lila Weston Institute of Neurological Studies and The National Hospital for Neurology and Neurosurgery, London, UK
  4. 4
    Wales Institute of Cognitive Neuroscience, School of Psychology, Cardiff University, Cardiff, UK
  1. Professor A J Lees, Reta Lila Weston Institute of Neurological Studies, Windeyer Building, 46 Cleveland Street, London W1T 4JF, UK; alees{at}


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

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

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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  • Competing interests: None.

  • Ethics approval: The study was approved by the Joint Ethics Committee of the National Hospital for Neurology and Neurosurgery and Institute of Neurology.