If I understand the question correctly, there are no plans to replace Madopark with any other anti-Parkinson’s medication. If that is the case, this is an unusual course of events, but it suggests that the patient does not have Parkinson’s disease, for which they have been treated with Madopark. In this situation, where the patient does not have Parkinson’s disease, it is entirely possible to stop treatment without experiencing withdrawal symptoms. L-dopa has a short half-life and is rapidly eliminated from the body. The lingering biological effects of a period of L-dopa treatment on a dopamine system that is essentially intact (i.e. the patient does not have Parkinson’s disease) do not lead to withdrawal problems.
However, if you have Parkinson’s disease and stop taking 700 mg of Madopark without replacing it with another medication, this will lead to a manifest dopamine deficiency within a short time after stopping the medication. How long it takes for symptoms to appear varies from person to person and depends partly on how long you have had the disease and how long you have been taking the medication, as well as whether other anti-Parkinson’s medicines are included in your treatment. Tremors, rigidity and slowed movements, amongst other symptoms, are likely to recur.
SweModis’ recommendations regarding treatment are generally to combine different classes of anti-Parkinson’s medication if it is likely that the patient can tolerate the various types of medication.
Changes in Parkinson’s medication are common, for example when switching from tablets to pump therapy, combination therapy with DBS, or switching between different types of medication, such as by adding an enzyme inhibitor or switching to combination therapy. In such cases, several doses may sometimes be changed all at once or over a period of time, and it is then necessary to calculate the expected effects. Levodopa-equivalent doses (LED) are a method of calculating what the new medication corresponds to. For example, the effect of 700 mg of Madopark (7 x 100 mg Madopark) can be replaced by other medicines, such as Stalevo 125 mg x 4. The four Stalevo tablets contain the same amount as the seven Madopark tablets. /Håkan Widner