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(carbidopa/levodopa intestinal gel)

  • There are many new therapies used in this day and age to treat Parkinson disease. Many of them are aimed at delivering dopamine, a chemical that is low in Parkinson disease, to the brain via different routes.

  • Traditionally, dopamine is replaced with oral medication but erratically absorbed as the disease progresses. This creates fluctuating offs and ons as well as troublesome dyskinesia. (excessive movement.)

  • One of the newer therapies, at least new in the United States as has been around in Europe for years, is carbidopa/levodopa intestinal gel.

  • This is essentially the same carbidopa/levodopa in the pill form except delivered directly into the jejunum, the second part of the small intestine. By delivering the medication in this location and bypassing the stomach and first part of the small intestine, the dopamine is better absorbed leading to less off time and more on time without troublesome dyskinesia.

  • This therapy is good for people with problematic offs and ons as well as troublesome dyskinesia. In addition, we find it to work well in people who have poor absorption of dopamine and in those who dopamine doesn't kick in fast enough. 

  • Many times, the oral medications for Parkinson Disease can be discontinued in those who have the Duopa pump. 

  • The medication is delivered via pump through a connection into the small intestine.  This is called a PEG-J tube.  It is important to note that this is NOT a feeding tube. 

  • The pump can be removed temporarily allowing the patient to swim, take a bath, etc.

  • The PEG-J tube is reversible making it a good option for those who are needing more help than what their traditional oral medications can do. 

  • Patients will often find the Duopa kicks in quickly and has a continuous sustainable effect throughout the day since the medication is delivered continuously.  Most do not need it throughout the night but their are exceptions. 

  • While it is difficult for patients and their family to grasp this concept, we encourage you to talk to your movement disorder specialist and certainly other patients who have had this performed.  The before and after videos are quite impressive. 

  • For more information, please contact us at Texas Movement Disorder Specialists, PLLC. 

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