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ich m1 danke It is about 4% coarser than average-grade material in the latter cases. It is not known to what extent anticholinergics induce side effects, and there is a possibility that they may not be helpful in all patients. And, to have one more test and this is not the best and most reliable test available. It has been demonstrated that levodopa in high doses, does not cause the same postural imbalance as other dopaminergic drugs. A rare movement disorder that may present as one of the three cardinal manifestations of the disease is action tremor. Levodopa combined with decarboxylase inhibitors, e. In some cases, a combination of dopaminergic drugs may be required to control tremor. For this patient, a high dose of carbidopa-levodopa (combination of an inhibitor of peripheral decarboxylase, levodopa ) was tried in divided doses in addition to a low dose of trihexyphenidyl to treat insomnia. Table 11. It is known that prolactin levels increase with time after the use of antipsychotics and that they reach maximum levels after about two weeks of use. The development of akathisia in these patients could also have been related to the low dose of flupenthixol used as monotherapy. This was followed by progressive debility, gait ataxia, and dysphagia with increased secretions. When any one of these symptoms begins to occur, the drug is stopped and symptomatic treatment instituted. On the other hand, doses of dopaminergic drugs needed to maintain a satisfactory levodopa response in idiopathic akathisia are between 100 and 500 mg/day (1). Levodopa-carbidopa is also administered, and sometimes clonazepam, tiapride, or zonisamide is used. The two common symptoms of Parkinson disease are tremor and bradykinesia. Of the involuntary movements, tremor is the most disabling to the patient and can usually be treated effectively with a dopaminergic medication. We have used it for that purpose. Some of the authors have published their findings about this drug in the previous chapter. First of all, it must be noted that only partial improvement of rigidity and akathisia can be achieved. In some of the patients, when deterioration of motor function and akathisia occurs, it is necessary to increase the dose of antiparkinsonian medication.