From the Research
Antipsychotics Safe to Use with High-Dose Carbidopa/Levodopa (Sinemet)
- Quetiapine is the most frequently coprescribed antipsychotic with levodopa, with a low potential for clinically relevant interactions and efficacy against psychosis in levodopa-treated patients 1
- Clozapine is also commonly used in combination with levodopa, although its coprescription has decreased since the introduction of quetiapine 1
- Olanzapine has been used in combination with levodopa, but its coprescription has also decreased over time 1
- Other antipsychotics, such as risperidone, haloperidol, and ziprasidone, are less commonly used in combination with levodopa and their use is not well supported by evidence 1
Considerations for Antipsychotic Use with High-Dose Carbidopa/Levodopa (Sinemet)
- Antagonistic interactions on dopamine receptors between levodopa and antipsychotics should be considered when coprescribing these medications 1
- The efficacy and safety of combining antipsychotics with levodopa should be carefully evaluated, as the evidence for some combinations is limited 1
- The choice of antipsychotic to use in combination with levodopa should be based on the individual patient's needs and the potential for clinically relevant interactions 1