The study "Levodopa: faster and better word learning in normal humans" used carbidopa in combination with the l-dopa, as do the vast majority of studies examining the possible effects of l-dopa - reflecting a basic metabolic reality. GTE is a COMT, rather than decarboxylase, inhibitor, and no studies have been conducted using the combination to enhance absorption of L-Dopa, or any clinical comparisons made, between the two inhibitor substances. Assuming L-Dopa does reach the brain, there is a lot of concern in the literature on the subject about possible neurotoxicity, including recently a finding on the association between brain iron content and l-dopa administration.
QUOTE
Mol Pharmacol. 2006 Mar;69(3):968-74. Epub 2005 Nov 29.
Increased divalent metal transporter 1 expression might be associated with the neurotoxicity of L-DOPA.
Chang YZ, Ke Y, Du JR, Halpern GM, Ho KP, Zhu L, Gu XS, Xu YJ, Wang Q, Li LZ, Wang CY, Qian ZM.
Department of Applied Biology and Chemistry Technology, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
Based on the available data, we speculated that changes in brain iron metabolism induced by L-DOPA might be associated with the neurotoxicity of L-DOPA. To investigate this possibility, the effects of L-DOPA on the expression of iron influx proteins [transferrin receptor (TfR) and divalent metal transporter 1 (DMT1)], iron efflux protein (ferroportin 1), and iron uptake in C6 glioma cells were determined in this study using Northern blot and Western blot analysis and the calcein method. The findings showed that treatment of C6 cells with different concentrations of L-DOPA (0-100 microM) did not affect the expression of mRNA and protein of TfR and DMT1 with iron-responsive element (+IRE) and protein of ferroportin 1. However, a significant increase in the expression of DMT1(-IRE) mRNA and protein was found in cells treated, respectively, with 10 and 30 microM L-DOPA (mRNA) and 1, 5, 10 and 30 microM L-DOPA (protein). The increase in DMT(-IRE) protein induced by L-DOPA treatment was in parallel with the increase in DMT(-IRE) mRNA. The levels of DMT1(-IRE) mRNA and protein peaked in the cells treated with 10 microM L-DOPA and then decreased progressively with increasing concentrations of L-DOPA. Further study demonstrated that treatment of the cells with 10 microM L-DOPA induced a significant increase in ferrous uptake by C6 glioma cells. The findings suggested that the increased DMT1(-IRE) expression might be partly associated with the neurotoxicity of L-DOPA. Clinical relevance of the findings needs to be investigated further.
To name one of many studies looking at the neurotoxic effects of l-dopa, with most looking at the mechanism, rather than the actual existence, of neurotoxic effects. To be fair, melatonin has been reported to decrease the deleterious effects of l-dopa, so maybe a combination would be more effective.
QUOTE
Brain Res. 2005 Nov 30;1063(2):180-6. Epub 2005 Oct 28.
l-DOPA administration enhances 6-hydroxydopamine generation.
Maharaj H, Sukhdev Maharaj D, Scheepers M, Mokokong R, Daya S.
Division of Pharmacology, Faculty of Pharmacy, Rhodes University, P.O. Box 94, Grahamstown, 6139, South Africa.
The therapeutic success of L-3,4-dihydroxyphenylalanine (L-DOPA) treatment in Parkinson's disease (PD) patients remains controversial as many patients become tolerant requiring higher dosage regimens. However, the increase in dosage regimens results in the patients experiencing intolerable side effects. This study sought to investigate whether dopamine (DA) can chemically react with iron to form the potent neurotoxin 6-hydroxydopamine (6-OHDA). Furthermore, rats were treated with L-DOPA for a period of 7 and 28 days to determine whether L-DOPA treatment results in 6-OHDA formation in rat striatum. In addition, this study also investigates the complex interactions of L-DOPA with iron by performing in vitro and in vivo lipid peroxidation studies and the detection of endogenous 6-OHDA in iron-infused rats. In each study, melatonin was used to determine whether it could quench any free radical effects that may occur. The results of the present study show that DA chemically reacts with iron to form 6-OHDA. Moreover, L-DOPA treatment results in endogenous 6-OHDA formation in rat brain as well as enhances iron-induced lipid peroxidation both in vitro and in vivo in the rat striatum. The L-DOPA-induced increase in lipid peroxidation, in iron-infused rats, corresponds with an increase in levels of 6-OHDA in the rat striatum. The use of melatonin significantly decreases the L-DOPA-stimulated 6-OHDA formation in the rat striatum. The present study provides novel information on L-DOPA-induced neurotoxicity and suggests the concomitant use of an antioxidant with L-DOPA in order to enhance the life span of L-DOPA therapy.
PMID: 16257392