The options for treating advanced-stage Parkinson’s disease are quite limited. Both globally and in Turkey, there are treatments available such as Deep Brain Stimulation (DBS) and Apomorphine injection pump. In recent years, another alternative has been added to these treatments in our country. Levodopa/Carbidopa Intestinal Gel, also known as Duodopa, is a treatment in which Levodopa, which is considered the gold standard in Parkinson’s disease treatment, is continuously infused in a gel form through the small intestine.

This gel is administered directly to the jejunum, a part of the small intestine, in a continuous infusion form through a special pump called the Duodopa pump. By delivering Levodopa directly to the location where it is best absorbed, it allows for rapid access to the brain and conversion to dopamine, thus enabling its effectiveness.

The programmable nature of the Duodopa pump allows for the individualization of the daily Levodopa dose according to each patient’s needs, and even enables readjusting the treatment dose if necessary. By administering the patient’s daily Levodopa requirement in continuous and stable doses, fluctuations in the drug’s blood levels are minimized, resulting in a significant reduction in unwanted effects. Duodopa is administered using a system called percutaneous endoscopic gastrojejunostomy. This system is installed into the stomach and extended towards the small intestine through an intestinal tube. The Duodopa pump is attached to the end of the tube that remains outside. Numerous studies have shown that Duodopa is more effective than oral treatments in improving motor fluctuations and quality of life. It is particularly important for patients who experience motor fluctuations and involuntary movements, have tremors and/or stiffness due to inadequate response to medication, experience a decreased response to medication over time, or are unable to tolerate oral medication.

Thanks to pump therapy, medications are delivered to the body and brain more continuously, leading to better control of disease symptoms. This treatment eliminates the need for taking medication orally multiple times throughout the day.