Can L-dopa Madopark cause diarrhea?/nIn that case is it dose-related?/nAn 85-year-old woman has bee

Fråga: Can L-dopa Madopark cause diarrhea?

In that case is it dose-related?

An 85-year-old woman has been treated with citalopram (Cipramil) for a long time. When L-dopa treatment was added (because of Parkinson´s disease) and especially when the dose was increased the patient developed diarrhea.

Sammanfattning: There are a few Swedish case reports concerning diarrhea caused by L-dopa. In the present case the temporal relationship between onset of diarrhea and initiation of L-dopa treatment supports an assumption of a causal relationship, though the patient was concomitantly treated with citalopram which is also known to cause the same symptom. A switch to carbidopa treatment could be considered.

Svar: A Medline search has not revealed any literature on the subject (1).

In the Swedish database of adverse drug reactions there are six cases where diarrhea has been judged a possible or probable adverse reaction to L-dopa. In one of the cases the diarrhea disappeared when L-dopa was exchanged for carbidopa (Sinemet)(2).

Diarrhea is a well known side effect to citalopram therapy (3). However, this problem is usually more pronounced in the beginning of citalopram treatment.

We recommend this case be reported to SADRAC (2). 1 Medline 1966 to present 2 SADRAC (Swedish Adverse Drug Reactions Advisory Committee) 3 FASS (The Swedish catalogue of approved medical products) 1997; 268