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Liothyronine with levodopa in parkinsonism.

To the Editor.— Since levodopa treatment of parkinsonism is attended by significant side effects, efforts have been directed at improving its therapeutic efficiency. 1 The simultaneous use of a drug that blocks peripheral decarboxylation of the amino acid has been promising. 2 For the following reasons we entertained the possibility that a small dose of the thyroid hormone, liothyronine sodium, might potentiate the beneficial effects of levodopa. First, this hormone has been shown to potentiate the antidepressant activity of imipramine 3,4 and amitriptyline. While the mechanism of interaction is unproved, it plausibly involves augmentation of central adrenergic processes. 3 Hyperthyroid patients occasionally show a chorea that resembles the chorea seen in patients with parkinsonism after overdosage with levodopa. 5 Hypothyroid infants often show muscle hypertonia, a usual finding in patients with parkinsonism, and treatment with thyroid hormone reduces it. 6 Guided by these observations we treated seven patients with idiopathic parkinsonism with