Rotigotine Patch is Effective for Levodopa (L-Dopa)-Induced Dyspnea: A Case Report

Parkinson's disease (PD) is a progressive neurodegenerative disorder with increasing prevalence. While commonly recognized motor symptoms include mobility limitations and balance problems, less attention has been given to respiratory complications related to levodopa (L-dopa) treatment, particularly dyspnea. This report describes an 88-year-old woman with a long-standing history of PD who presented with fever, dyspnea, and dysphagia after being treated with L-dopa. Upon admission, her neurological examination revealed significant motor impairments, and chest imaging indicated right diaphragmatic elevation and passive atelectasis. Despite adjustments to her treatment regimen, including switching from intravenous to nasogastric L-dopa administration, she experienced severe dyskinesias and respiratory distress. Given her history of L-dopa-induced respiratory issues, we transitioned her treatment to a transdermal rotigotine patch. Remarkably, the switch resulted in complete resolution of her respiratory symptoms and dyskinesia, alongside improvements in her overall motor functions and activities of daily living. This case underscores the potential effectiveness of rotigotine as a treatment strategy for L-dopa-induced dyspnea, suggesting it may maintain stable blood concentrations and mitigate dyskinesias. Further investigation is warranted to explore the underlying mechanisms of L-dopa-induced respiratory depression and validate the therapeutic role of rotigotine in these cases.