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If you have been diagnosed with Parkinson’s disease and levodopa treatment is not working, it is possible that you are suffering not from Parkinson’s disease but from a different condition with similar symptoms. Manganism, or manganese poisoning, is one such condition.

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Levodopa Information

What is levodopa?

Levodopa is one of several drugs used to treat Parkinson’s disease. A progressive disorder, Parkinson’s disease is associated with the reduced production of dopamine (an important neurotransmitter) by the brain. This, in turn, leads to problems with movement and coordination that worsen over time. Levodopa helps to mitigate movement problems because of its chemical similarity to dopamine. In fact, levodopa is converted into dopamine once inside the body. Levodopa is not a cure for Parkinson’s; it only offers relief of symptoms associated with it.

In general, levodopa is considered the most effective treatment available for Parkinson’s disease and its symptoms. Levodopa is often given in combination with another drug called carbidopa. This combination is known as Sinemet. It may provide significant benefit for five or more years. Like all drugs used to treat Parkinson’s disease, however, levodopa is associated with certain side effects. Patients may experience stomach upset and vomiting when they first start taking levodopa. Later, long-term problems may develop. Tics, dyskinesia (an impairment of voluntary movements), and unresponsiveness are common after long-term use. Raising a patient’s dosage of levodopa (which is sometimes done when the disease progresses) increases the likelihood of undesirable side effects.

Levodopa is often used before, after, or alongside dopamine agonists, drugs that perform functions similar to dopamine. When a Parkinson’s patient’s symptoms progress, dopamine agonists can be used to augment levodopa treatment in lieu of raising the dosage of levodopa. For some patients the combination of levodopa and dopamine agonists may prevent the undesirable side effects that can occur when taking higher doses of levodopa alone.

What is Parkinson’s disease?

Parkinson’s disease is a progressive condition in which the part of the brain responsible for controlling movement stops functioning properly. As the nerve cells in this area of the brain deteriorate, production of an important neurotransmitter, dopamine, declines. With diminished levels of dopamine, patients experience problems with balance, muscle control, and movement. Tremors, difficulty walking, and stiffening of the muscles are some of the more common symptoms. In advanced cases, patients may experience depression, hallucinations, and dementia. Parkinson’s disease is most common among people over age 50, but it can affect younger people as well. The cause of Parkinson’s disease is unknown.

Although there is no known cure for Parkinson’s disease, treatment can help control symptoms and improve patients’ quality of life. Medications, such as levodopa, are usually the first treatments administered. Other drugs, such as dopamine agonists or antihistamines, may be needed to help offset the side effects of the primary treatment drugs. Patients with Parkinson’s disease are encouraged to follow healthy eating and exercise habits. Physical therapy and counseling may boost independence and help patients cope with their disorder. Surgery is used much less frequently but may be performed in an attempt to alleviate tremors and other problems.

What should I do if levodopa treatment is not working?

Levodopa is considered the most effective treatment available for Parkinson’s disease. Most patients experience a decrease in the frequency and severity of their symptoms while taking levodopa. If you have been diagnosed with Parkinson’s disease and levodopa treatment is not working, it is possible that you are suffering not from Parkinson’s disease but from a different condition with similar symptoms. Manganism, or manganese poisoning, is one such condition.

Workers in the welding rod industry are regularly exposed to manganese, a metallic chemical element. Although the body actually requires small amounts of manganese, overexposure can lead to the development of a condition called manganism, or manganese poisoning. Manganism is often classified as a Parkinson’s syndrome, because although it differs from Parkinson’s disease in cause and pathology, the two disorders share similar symptoms. Welders have an increased risk of developing manganese poisoning. They may experience tremors, problems with balance, depression, and other Parkinson’s-like effects. For these welding rod workers, a misdiagnosis of Parkinson’s disease poses several problems. Treatments like levodopa, which work well for Parkinson’s patients, have no effect on manganism patients. If they are misdiagnosed with Parkinson’s disease, welders suffering from manganese poisoning may fail to receive compensation from their employers even though their exposure to manganese occurred on the job.

If you work in the welding rod industry and have been diagnosed with Parkinson’s disease, you may want to consider seeking a second opinion. Levodopa treatment may not work for you, because you may be suffering from manganism rather than Parkinson’s disease. If this is the case, you may be eligible for a free manganese poisoning screening.