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NEUROLOGY 1987;37:1607
© 1987 American Academy of Neurology

Controlled-release levodopa/carbidopa.

II. Sinemet CR4 treatment of response fluctuations in Parkinson's disease

Jesse M. Cedarbaum, MD, Lyn Breck, RN, Henn Kutt, MD and Fletcher H. McDowell, MD

From the Department of Neurology, The Burke Rehabilitation Center, White Plains, and the New York Hospital-Cornell Medical Center, New York, NY.

Sixteen patients with Parkinson's disease and therapeutic response fluctuations entered an open-label trial of a controlled-release carbidopa/levodopa preparation, Sinemet CR4. Sinemet CR4 behaved as a slow release preparation. At the end of 6 weeks CR4 treatment, there was an increase in percent "on" time and mean interdose interval; the number of daily doses and "off" periods were diminished and a slight reduction in the variability of plasma levodopa levels was observed. Overall benefit waned over the next 6 months, despite addition of standard levodopa or Sinemet to overcome the delayed onset of antiparkinso-nian effect of CR4 which resulted from prolongation in the Tmax for levodopa. The major benefits of CR4 were reduction in off time and in the number of daily off periods, with fewer levodopa doses per day and prolongation of the interdose interval.

Address correspondence and reprint requests to Dr. Cedarbaum, Department of Neurology, The Burke Rehabilitation Center, 785 Mamaroneck Avenue, White Plains, NY 10605.

Supported in part by the Winifred Masterson Burke Relief Foundation; the Harold G. and Leila Y. Mathers Charitable Foundation; the Shirley Winkler Parkinson Research Fund of the Burke Rehabilitation Center; PHS research grant RR0047 from the Division of Research Resources, NIH, and Merck, Sharp & Dohme, Inc.

Presented in part at the 111th meeting of the American Neurological Association, Boston, MA, October 7, 1986.

Received October 28, 1986. Accepted for publication in final form January 12, 1987.






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