Low-dose L-dopa therapy in Parkinson's disease

A 6-year follow-up study

Poewe, W. H.
Lees, A. J.
Stern, G. M.

Department of Neurology, The Middlesex Hospital, London, UK.

Address correspondence and reprint requests to Dr. Lees, Department of Neurology. The Middlesex Hospital, Mortimer Street, London, W 1, UK.

Accepted for publication March 5, 1986.

Neurology 36(11):p 1528-1530, November 1986.

Article abstract

Thirty-five patients with early mild Parkinson's disease were treated from the outset with small doses of L-dopa (mean dose, 396 to 454 mg daily) and a peripheral decarboxylase inhibitor, for a mean of 6 years. Overall mortality ratio was 1.2:1, worse for women than for men. After 6 years of treatment, only one-third of patients were better, and drug-related complications were common (peak-dose dyskinesias in 54% of patients, off-period dystonia 20%, wearing-off effects 52%, on-off oscillations 6%, visual hallucinations and toxic confusional states 17%). We found no evidence that long-term results were markedly improved with low-dose regimens.