Some ‘dopamine bean’ supplements show high levels of Parkinson’s disease drug

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A type of supplement known as a “dopamine bean” may contain very high levels of levodopa – in some cases higher than prescription formulations used to treat Parkinson’s disease, researchers have found.

Among 15 brands of Mucuna pruriens supplements, levodopa content ranged from 2 mg to 241 mg, and the latter amount was close to the maximum prescription levodopa dose available, which ranges from 50 to 250 mg, Pieter Cohen, MD, of Cambridge Health Alliance in Massachusetts , and his colleagues reported in a research letter in JAMA Neurology.

Cohen said the high doses of levodopa found in these supplements “pose direct challenges to the management of patients with Parkinson’s disease who use these supplements. The dose of levodopa the patient receives would be much higher than we think. that the patient uses based on our prescribed medication.”

Outside of Parkinson’s disease, people who use them solely for their dopamine effects could experience a “wide variety of serious side effects, including paranoia and psychosis,” Cohen said. MedPage today.

Cohen said he and his team have begun to investigate Mucuna supplements after worried parents said they thought their son was having serious psychiatric effects from the products and would not stop using them.

Mucuna the supplements are “marketed from Amazon to Vitamin Shoppe for their dopamine effects, to help with mood, workouts, focus, energy — you name it,” Cohen said. The natural bean contains small amounts of levodopa, the precursor of dopamine.

How often Mucuna is used in the United States is not known, but the researchers cited a recent survey of 205 patients with Parkinson’s disease which found that 7% of those who used supplements took Mucuna some products.

To expand on their previous work on how “botanical” supplements are actually formulated as potent drugs, Cohen and colleagues searched the NIH Dietary Supplement Label Database in November 2021 to identify supplements with Mucuna pruriens On the label. They shopped online for the 20 most recently added brands to the database in 2021.

They also obtained two samples of Mucuna pruriens seeds from the National Center for Natural Products Research repository at the University of Mississippi to determine the amount of levodopa in the seed extract.

In the end, of the 20 samples, one was not available, one was a duplicate entry, and two did not have both”Mucuna pruriensand “dietary supplement” on the label, so the researchers ended up with 16 products. Of these, one product contained no detectable levels of levodopa.

For Mucuna seed extract, authenticated samples contained 2.5% to 3.9% levodopa. But among Mucuna supplements that listed a specific amount of seed extract on the label, the actual amount of levodopa was 228% to 2186% higher than the estimated amount.

The researchers cautioned that it is not possible to directly compare the pharmacological effects of levodopa in Mucuna supplements with prescription levodopa because pharmaceutical versions include a peripheral decarboxylase inhibitor – which limits the conversion of levodopa to dopamine – which is not present in Mucuna supplements.

Cohen said MedPage today that side effects will be “very difficult to predict” because it “will depend on how much levodopa in these supplements enters the central nervous system.” Nonetheless, he said, excess dopamine “can lead to a wide range of adverse effects, including agitation, impulse control disorders, peripheral neuropathies, and orthostatic hypotension.”

The researchers noted that their study was limited because they only analyzed two seed extract samples, so it is possible that other variants of Mucuna pruriens or different extraction methods may affect the amount of levodopa. Additionally, only one sample of each supplement brand was analyzed, so it is not known if levodopa doses vary from batch to batch.

Yet they concluded that “clinicians can identify unsuspected levodopa use by asking patients about supplement use and advising them that levodopa use M. pruriens supplements can unpredictably complicate the management of Parkinson’s disease and other illnesses.”

  • Kristina Fiore leads MedPage’s corporate reporting and investigative team. She has been a medical journalist for over a decade and her work has been recognized by Barlett & Steele, AHCJ, SABEW and others. Send story tips to [email protected] Follow

Disclosures

Cohen said he received grants from The Pew Charitable Trusts and Consumers Union and was the subject of a civil lawsuit by Hi-Tech Pharmaceuticals, a supplement company (the jury found in favor of Cohen), both outside of the submitted work.

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