FLUCTUATING PARKINSONISM - A PILOT-STUDY OF SINGLE AFTERNOON DOSE OF LEVODOPA METHYL-ESTER

Thirty-four patients with idiopathic fluctuating Parkinson's disease a nd early afternoon ''delayed on'' or severely resistant ''off'' period s, in spite of long-term antiparkinsonian therapy, were studied. The f irst afternoon levodopa administration was substituted with an equimol ar dosage of the liquid formulation levodopa methyl ester (LDME). The major end-points for efficacy were latency to ''on'' and duration of ' 'on'' periods. The patients were divided into five subgroups according to their baseline treatment and they were evaluated monthly for 6 mon ths using the Unified Parkinson's Disease Rating Scale. The patients c ompleted weekly self-evaluation using an ''on-off'' chart. LDME was we ll tolerated by all the patients. A statistically significant reductio n in latency to ''on'' was observed in all patients. The clinical effe ct of LDME remained stable during the treatment period (repeat measure s ANOVA). The more rapid clinical effect of LDME and its stable and pr edictable antiparkinsonian activity represents a new and useful approa ch for treating patients with complicated Parkinson's disease.