Levodopa dose adjustment versus adjunctive therapy in Parkinson’s disease 

Angelo Antonini, MD, PhD, University of Padua, Padua, Italy, discusses the best option when noticing that a patient with Parkinson’s disease (PD) is starting to experience wearing off effects of levodopa. Firstly, clinicians can increase the number of levodopa administrations a day. Alternatively, one can use adjunctive medications that would instead extend the effect of the existing levodopa tablets taken by the patient. According to a survey given to general neurologists and movement disorder specialists, the most common approach was to increase levodopa dosage. Prof. Antonini proposes otherwise and recommends that clinicians should consider using drugs, such as opicapone, that extend the effect of existing levodopa. Opicapone is especially attractive as it is only taken once a day, whilst increasing levodopa intake correlates with poorer adherence, due to the difficulty for patients to remember the complex treatment schedules. This interview took place at the European Academy of Neurology (EAN) 2022 Congress in Vienna, Austria.