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Levodopa alone and in combination with a peripheral decarboxylase inhibitor benserazide (madopar®) in the treatment of Parkinson's disease

A controlled clinical trial

  • Original Investigations
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Summary

A combination of levodopa and the extracerebrally acting decarboxylase inhibitor benserazide (ratio 4:1) (Madopar®), was compared with levodopa alone in a controlled double-blind clinical multicenter trial on 94 patients with Parkinson's disease. During 4 months of therapy levodopa + benserazide proved superior to levodopa on several accounts. Nausea and vomiting occurred with statistically significant less severity and frequency. Clinical improvement expressed through improvement in Webster rating occurred sooner and was all together greater.

The treatment schedules did not differ with regard to other side effects, in particular involuntary movements and reduction in supine blood pressure. Neither treatment seemed to influence liver function, renal function and hematological parameters.

Zusammenfassung

Levodopa in Kombination mit dem extracerebral wirkenden Dekarboxylasehemmer Benserazid (Dosisverhältnis 4:1) (Madopar®) wurde mit Levodopa allein in einer kontrollierten, doppelblinden, klinischen Multizenterprüfung an 94 Patienten mit Morbus Parkinson verglichen. Während der viermonatigen Therapie zeigte sich in mehreren Beziehungen Levodopa + Benserazid dem Levodopa überlegen. Übelkeit und Erbrechen waren statistisch signifikant weniger schwerwiegend und traten seltener auf. Klinische Besserung, ausgedrückt durch Reduktion im Webster Rating, trat schneller ein und war im großen und ganzen höher.

Andere Nebenerscheinungen, insbesondere unwillkürliche Bewegungen und Reduktion des Blutdruckes im Liegen, verteilen sich gleich über die beiden Gruppen. Bestimmungen von sowohl Leberfunktion und Nierenfunktion als auch hämatologischen Parametern ergaben keine signifikanten Änderungen.

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References

  1. Barbeau, A.: Treatment of Parkinson's disease with L-Dopa and Ro 4-4602: Review and present status. Advances in Neurology 2, 173–198 (1973). New York: Raven Press Publishers

    Google Scholar 

  2. Bartholini, G., Burkard, W. P., Pletscher, A., Bates, H. M.: Increase of cerebral catecholamines caused by 3,4-dihydroxyphenylalanine after inhibition of peripheral decarboxylase. Nature (Lond.) 215, 852–853 (1967)

    Article  CAS  PubMed  Google Scholar 

  3. Bartholini, G., Pletscher, A.: Cerebral accumulation and metabolism of 14C-dopa after selective inhibition of peripheral decarboxylase. J. Pharmacol. exp. Ther. 161, 14–20 (1968)

    CAS  PubMed  Google Scholar 

  4. Birket-Smith, E.: Abnormal involuntary movements induced by anticholinergic therapy. Acta neurol. scand. 50, 801–811 (1974)

    CAS  PubMed  Google Scholar 

  5. Birket-Smith, E.: Abnormal involuntary movements in relation to anticholinergics and levodopa therapy. Acta neurol. scand. (in press)

  6. Calne, D. B., Stern, G. M., Spiers, A. S. D., Laurence, D. R.: L-DOPA in idiopathic parkinsonism. Lancet 1969 II, 973–976

    Article  Google Scholar 

  7. Constantinidis, J., Torre, J. C. de la, Tissot, R., Geissbuhler, F.: La barrière capillaire pour la dopa dans le cerveau et les différents organes. Psychopharmacologia (Berl.) 15, 75–87 (1969)

    Article  CAS  PubMed  Google Scholar 

  8. Constantinidis, J., Siegfried, J., Frigyesi, T. L., Tissot, R. J.: Parkinson's disease and striatal dopamine: In vivo morphological evidence for the presence of dopamine in the human brain. Neural Trans. 35, 13–22 (1974)

    Article  CAS  Google Scholar 

  9. Dupont, E., Hansen, E., Melsen, S., Pakkenberg, H., Holm, P.: Treatment of parkinsonism with a combination of levodopa and the decarboxylaseinhibitor Ro 4-4602 (a comparison with levodopa treatment alone). Acta neurol. scand. 48, Suppl. 51, 115–117 (1972)

    Google Scholar 

  10. Fahn, S., David, E.: Oral dyskinesia secondary to anticholinergic drugs. Exc. Med. Intern. Congr. Series (10th Intern. Congr. Neurol.) 296, 43 (1973)

    Google Scholar 

  11. Gerlach, J., Reisby, N., Randrup, A.: Dopaminergic hypersensitivity and cholinergic hypofunction in the pathophysiology of tardive dyskinesia. Psychopharmacologia (Berl.) 34, 21–35 (1974)

    Article  CAS  PubMed  Google Scholar 

  12. Holmsen, R., Kvan, L., Presthus, J., Thoresen, G. B.: Treatment of parkinsonism with a compound of L-Dopa (LARODOPA) and a decarboxylase inhibitor (Ro 4-4602). Acta neurol. scand. 48, Suppl. 51, 121–122 (1972)

    Google Scholar 

  13. Kiloh, L. G., Sydney Smith, J., Williams, S. E.: Antiparkinson drugs as causal agents in tardive dyskinesia. Med. J. Aust. 2, 591–593 (1973)

    CAS  PubMed  Google Scholar 

  14. Mano, T., Sobue, I., Hirose, K., Takagi, S., Watanabe, H., Okamoto, S.: Dyskinesias induced by anticholinergic drugs. An electrophysiological analysis. Exc. Med. Intern. Congr. Series (10th Intern. Congr. Neurol.) 296, 44 (1973)

    Google Scholar 

  15. Mars, H.: Modification of levodopa effect by systemic decarboxylase inhibition. Arch. Neurol. 28, 91–95 (1973)

    CAS  PubMed  Google Scholar 

  16. Pakkenberg, H., Dupont, E., Garde, K., Hansen, E., Melsen, S., Westberg, F.: Levodopum og parkinsonisme. Ugeskr. Læg. 133, 2275–2279 (1971)

    CAS  PubMed  Google Scholar 

  17. Pletscher, A., Bartholini, G.: Selective rise in brain dopamine by inhibition of extracerebral levodopa decarboxylation. Clin. Pharmacol. Ther. 12, 344–352 (1971)

    CAS  PubMed  Google Scholar 

  18. Presthus, J., Holmsen, R.: Appraisal of long-term levodopa treatment of parkinsonism with special reference to therapy limiting factors. Acta neurol. scand. 50, 774–790 (1974)

    CAS  PubMed  Google Scholar 

  19. Rinne, U. K., Sonninen, V.: A double blind study of L-Dopa treatment in Parkinson's disease. Europ. Neurol. 1, 180–191 (1968)

    Article  CAS  PubMed  Google Scholar 

  20. Rinne, U. K., Sonninen, V., Siirtola, T.: Treatment of Parkinson's disease with L-DOPA and decarboxylase inhibitor. J. Neurol. 202, 1–20 (1972)

    Article  CAS  Google Scholar 

  21. Rinne, U. K., Sonninen, V., Siirtola, T.: Plasma concentration of Levodopa in patients with Parkinson's disease. Europ. Neurol. 10, 301–310 (1973)

    Article  CAS  PubMed  Google Scholar 

  22. Rinne, U. K., Sonninen, V.: Brain catecholamines and their metabolites in parkinsonian patients. Arch. Neurol. 28, 107–110 (1973)

    CAS  PubMed  Google Scholar 

  23. Schneider, E., Fischer, P.-A., Jacobi, P., Maxion, H.: Wirkungsvergleich von L-Dopa und der Kombination L-Dopa + Decarboxylasehemmer beim Parkinson-Syndrom. Arch. Psychiat. Nervenkr. 217, 95–112 (1973)

    Article  CAS  PubMed  Google Scholar 

  24. Webster, D. D.: Critical analyses of the disability in Parkinson disease. Med. Treatment (New York) 5, 257–282 (1968)

    CAS  Google Scholar 

  25. Worm-Petersen, J., Dupont, E., Mikkelsen, B.: Levodopumbehandling af Parkinson's sygdom. Ugeskr. Læg. 133, 2321–2326 (1971)

    CAS  PubMed  Google Scholar 

  26. Yahr, M. D., Duvoisin, R. C., Schear, M. J., Barrett, R. E., Hoehn, M. M.: Treatment of parkinsonism with levodopa. Arch. Neurol. 21, 343–354 (1969)

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, University of Turku, Finland

    U. K. Rinne, M. Hyyppä & R. Marttila

  2. Department of Neurology, Aalborg Hospital South, Aalborg, Denmark

    E. Birket-Smith

  3. Department of Neurology, Kommunehospitalet, University of Aarhus, Denmark

    E. Dupont

  4. Department of Neurology, Vejle Hospital, Denmark

    E. Hansen

  5. Department of Neurology, Hjørring Hospital, Denmark

    B. Mikkelsen

  6. Department of Neurology, Kommunehospitalet, Copenhagen, Denmark

    H. Pakkenberg

  7. Department of Neurology, Ullevål Hospital, Oslo, Norway

    J. Presthus

Authors
  1. U. K. Rinne
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  2. E. Birket-Smith
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  3. E. Dupont
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  4. E. Hansen
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  5. M. Hyyppä
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  6. R. Marttila
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  7. B. Mikkelsen
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  8. H. Pakkenberg
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  9. J. Presthus
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Rinne, U.K., Birket-Smith, E., Dupont, E. et al. Levodopa alone and in combination with a peripheral decarboxylase inhibitor benserazide (madopar®) in the treatment of Parkinson's disease. J. Neurol 211, 1–9 (1975). https://doi.org/10.1007/BF00312459

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  • DOI: https://doi.org/10.1007/BF00312459

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