Presynaptic effects of levodopa and their possible role in dyskinesia

Mov Disord. 2015 Jan;30(1):45-53. doi: 10.1002/mds.26103. Epub 2014 Dec 1.


Levodopa replacement therapy has long provided the most effective treatment for Parkinson's disease (PD). We review how this dopamine (DA) precursor enhances dopaminergic transmission by providing a greater sphere of neurotransmitter influence as a result of the confluence of increased quantal size and decreased DA reuptake, as well as loading DA as a false transmitter into surviving serotonin neuron synaptic vesicles. We further review literature on how presynaptic dysregulation of DA release after l-dopa might trigger dyskinesias in PD patients.

Keywords: Parkinson's Disease; dopamine; dyskinesia; levodopa; presynaptic; serotonin.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Dopamine / metabolism
  • Dopamine Agents / adverse effects*
  • Dyskinesia, Drug-Induced* / etiology
  • Dyskinesia, Drug-Induced* / metabolism
  • Dyskinesia, Drug-Induced* / pathology
  • Humans
  • Levodopa / adverse effects*
  • Neurons / cytology*
  • Neurons / drug effects
  • Parkinson Disease / drug therapy
  • Presynaptic Terminals / drug effects*
  • Presynaptic Terminals / metabolism


  • Dopamine Agents
  • Levodopa
  • Dopamine