THE SYDNEY MULTICENTER STUDY OF PARKINSONS-DISEASE - A RANDOMIZED, PROSPECTIVE 5-YEAR STUDY COMPARING LOW-DOSE BROMOCRIPTINE WITH LOW-DOSE LEVODOPA-CARBIDOPA

149 previously untreated patients with Parkinson's disease were recrui ted over a three year period and randomly allocated to either low dose levodopa-carbidopa (less than or equal to 600/150 mg/day) or low dose bromocriptine (less than or equal to 30 mg/day). A five year follow u p is reported on the 126 patients who completed the dose titration and who have not developed features of atypical Parkinsonism. Levodopa-ca rbidopa in low dosage adequately controlled symptoms in most patients and delayed the appearance of dyskinesia and end of dose failure for a bout two years longer than conventional doses. Only a few patients cou ld be managed for more than one year on low dose bromocriptine alone; these patients had mild disease and asymmetric signs. Patients randomi sed to bromocriptine did not develop dyskinesia or troublesome end of dose failure until levodopa-carbidopa was added. The prevalence of dys kinesia in this group was lower than in patients given levodopa-carbid opa alone. The prevalence of end of dose failure was similar in the tw o randomisation groups once levodopa was introduced.