Short-term effect of a single levodopa dose on micturition disturbance in Parkinson’s disease patients with the wearing-off phenomenon
Uchiyama, T., R. Sakakibara, et al. (2003) Short-term effect of a single levodopa dose on micturition disturbance in Parkinson’s disease patients with the wearing-off phenomenon Movement Disorders, 18(5): 573-8
This article discusses that patients with PD typically have comorbid autonomic difficulties, including orthostatic hypotension, constipation, and micurition disturbances. They suggest these difficulties are caused by depletion of dopamine and catecholamines (chemicals in the brain). They suggest that the literature is mixed regarding the effect of L-dopa on bladder functioning in PD but cite methodological differences may be the explanation for such disparities in the research. They studied 18 patients (8 men, 10 women, mean age 64, mean age at onset 55, and mean duration of usage of L-dopa 8.7 years) with PD. Patients with dementia and major depression (description) were excluded. They looked at actual bladder function as well as patient opinion twice (in the morning about 12 hours after taking their last dose of L-dopa and one hour after taking their L-dopa). They found that high dose L-dopa (100mg) aggravated urinary urgency, and urge incontinence but improved motor functioning and ability to urinate efficiently. They suggest that areas in the brain may be overly sensitive to dopamine during the wearing off phase in PD, which is why a high dose of L-dopa would aggravate bladder dysfunction. They suggest that research in this area continues to be mixed and future researchers should look further into the causal factor(s) of bladder dysfunction in PD.