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The gut flora as a forgotten organ

& Kemler, M

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COMT normally converts: Levodopa 3-O-methyldopa (3-OMD) Dopamine metabolism also increases Tolcapone blocks COMT Increases levodopa levels in blood Increases levodopa delivery to brain Prolongs levodopa duration of action Reduces wearing-off symptoms Reduces motor fluctuations Special Point: Tolcapone inhibits COMT both in peripheral tissues and in the CNS, unlike entacapone (mostly peripheral)

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