Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1971 Dec;34(6):682–686. doi: 10.1136/jnnp.34.6.682

Failure of vitamin B6 to reverse the l-dopa effect in patients on a dopa decarboxylase inhibitor

Harold L Klawans 1, Steven P Ringel 1, David M Shenker 1
PMCID: PMC1083502  PMID: 5158783

Abstract

Seven patients with Parkinsonism previously on l-dopa were placed on a regimen of l-dopa and alpha methyl dopa hydrazine (a dopa decarboxylase inhibitor). Two of these patients had previously shown marked clinical deterioration of the l-dopa improvement when given pyridoxine. None of the seven patients receiving alpha methyl dopa hydrazine demonstrated any change in their condition when given pyridoxine. The failure of vitamin B6 to reverse the clinical effect of l-dopa in patients receiving both l-dopa and a peripheral dopa decarboxylase inhibitor suggests that reversal of the l-dopa effect induced by vitamin B6 is due to increasing the activity of the enzyme dopa decarboxylase outside the central nervous system.

Full text

PDF
682

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bartholini G., Burkard W. P., Pletscher A. Increase of cerebral catecholamines caused by 3,4-dihydroxyphenylalanine after inhibition of peripheral decarboxylase. Nature. 1967 Aug 19;215(5103):852–853. doi: 10.1038/215852b0. [DOI] [PubMed] [Google Scholar]
  2. Bartholini G., Pletscher A., Tissot R. On the origin of homovanillic acid in the cerebrospinal fluid. Experientia. 1966 Sep 15;22(9):609–610. doi: 10.1007/BF01895283. [DOI] [PubMed] [Google Scholar]
  3. Bertler A., Falck B., Owman C., Rosengrenn E. The localization of monoaminergic blood-brain barrier mechanisms. Pharmacol Rev. 1966 Mar;18(1):369–385. [PubMed] [Google Scholar]
  4. Bowers M. B., Jr Cerebrospinal fluid 5-hydroxyindoles and behavior after L-tryptophan and pyridoxine adminstration to psychiatric patients. Neuropharmacology. 1970 Nov;9(6):599–604. doi: 10.1016/0028-3908(70)90011-0. [DOI] [PubMed] [Google Scholar]
  5. CANTER G. J., DE LA TORRE R., MIER M. A method for evaluating disability in patients with Parkinson's disease. J Nerv Ment Dis. 1961 Aug;133:143–147. doi: 10.1097/00005053-196108000-00010. [DOI] [PubMed] [Google Scholar]
  6. Cotzias G. C., Papavasiliou P. S., Gellene R. Modification of Parkinsonism--chronic treatment with L-dopa. N Engl J Med. 1969 Feb 13;280(7):337–345. doi: 10.1056/NEJM196902132800701. [DOI] [PubMed] [Google Scholar]
  7. Crane G. E., Turek I. S., Kurland A. A. Failure of pyridoxine to reduce drug-induced dyskinesias. J Neurol Neurosurg Psychiatry. 1970 Aug;33(4):511–512. doi: 10.1136/jnnp.33.4.511. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. DEGKWITZ R., FROWEIN R., KULENKAMPFF C., MOHS U. [On the effects of L-dopa in man and their modification by reserpine, chlorpromazine, iproniazid and vitamin B6]. Klin Wochenschr. 1960 Feb 1;38:120–123. doi: 10.1007/BF02189076. [DOI] [PubMed] [Google Scholar]
  9. Duvoisin R. C., Yahr M. D., Coté L. D. Pyridoxine reversal of L-dopa effects in Parkinsonism. Trans Am Neurol Assoc. 1969;94:81–84. [PubMed] [Google Scholar]
  10. Ebadi M. S., Bostad R., Pellegrino R. J. Impairment of pyridoxal phosphate dependent metabolic reactions in a child with subacute necrotizing encephalopathy. J Neurol Neurosurg Psychiatry. 1969 Oct;32(5):393–398. doi: 10.1136/jnnp.32.5.393. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Gibbs D. A., Watts R. W. The action of pyridoxine in primary hyperoxaluria. Clin Sci. 1969 Oct;37(2):565–565. [PubMed] [Google Scholar]
  12. Hoehn M. M., Yahr M. D. Parkinsonism: onset, progression and mortality. Neurology. 1967 May;17(5):427–442. doi: 10.1212/wnl.17.5.427. [DOI] [PubMed] [Google Scholar]
  13. Hornykiewicz O. Dopamine (3-hydroxytyramine) and brain function. Pharmacol Rev. 1966 Jun;18(2):925–964. [PubMed] [Google Scholar]
  14. JACOB F., MONOD J. Genetic regulatory mechanisms in the synthesis of proteins. J Mol Biol. 1961 Jun;3:318–356. doi: 10.1016/s0022-2836(61)80072-7. [DOI] [PubMed] [Google Scholar]
  15. Klawans H. L., Jr A pharmacologic analysis of Huntington's chorea. Eur Neurol. 1970;4(3):148–163. doi: 10.1159/000114017. [DOI] [PubMed] [Google Scholar]
  16. Klawans H. L., Jr The pharmacology of parkinsonism (a review). Dis Nerv Syst. 1968 Dec;29(12):805–816. [PubMed] [Google Scholar]
  17. Klawans H., Jr, Ilahi M. M., Shenker D. Theoretical implications of the use of L-dopa in parkinsonism. A review. Acta Neurol Scand. 1970;46(4):409–441. doi: 10.1111/j.1600-0404.1970.tb05804.x. [DOI] [PubMed] [Google Scholar]
  18. LOVENBERG W., WEISSBACH H., UDENFRIEND S. Aromatic L-amino acid decarboxylase. J Biol Chem. 1962 Jan;237:89–93. [PubMed] [Google Scholar]
  19. MONOD J., CHANGEUX J. P., JACOB F. Allosteric proteins and cellular control systems. J Mol Biol. 1963 Apr;6:306–329. doi: 10.1016/s0022-2836(63)80091-1. [DOI] [PubMed] [Google Scholar]
  20. Pletscher A., Bartholini G., Tissot R. Metabolic fate of l-[14C] DOPA in cerebrospinal fluid and blood plasma of humans. Brain Res. 1967 Feb;4(1):106–109. doi: 10.1016/0006-8993(67)90154-0. [DOI] [PubMed] [Google Scholar]
  21. Sourkes T. L. Dopa decarboxylase: substrates, coenzyme, inhibitors. Pharmacol Rev. 1966 Mar;18(1):53–60. [PubMed] [Google Scholar]
  22. Tissot R., Gaillard J. M., Guggisberg M., Gauthier G., de Ajuriaguerra J. Thérapeutique du syndrome de Parkinson par la L-Dopa "per os" associée à un inhibiteur de la décarbosylase (Ro IV 46.02) Presse Med. 1969 Apr 5;77(17):619–622. [PubMed] [Google Scholar]
  23. Weiner W., Harrison W., Klawans H. L-dopa and cerebrospinal fluid homovanillic acid in Parkinsonism. Life Sci. 1969 Sep 1;8(17):971–976. doi: 10.1016/0024-3205(69)90428-7. [DOI] [PubMed] [Google Scholar]
  24. Yahr M. D., Duvoisin R. C., Schear M. J., Barrett R. E., Hoehn M. M. Treatment of parkinsonism with levodopa. Arch Neurol. 1969 Oct;21(4):343–354. doi: 10.1001/archneur.1969.00480160015001. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES