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Clinical experience with controlled-release carbidopa/levodopa in Parkinson's disease

Department of Neurology, University of Kansas Medical Center, Kansas City, KS.

We converted 158 Parkinson's disease (PD) patients on stable doses of standard carbidopa/levodopa (Std-L) to controlled-release carbidopa/levodopa (L-CR). Of the 141 patients who completed the study, 103 (73%) preferred L-CR, 26 (18.5%) preferred Std-L, and 12 (8.5%) had no preference. One hundred fourteen patients elected to continue L-CR, and we performed the primary data analysis on this group. Following conversion to L-CR, patients reported an increase in length of benefit from each dose and an increased "kick-in" time. There was a decrease in the total number of doses, "off periods, sleep interruptions per night, dose failures, and sleep disturbances. Conversion to L-CR resulted in a significant increase in total levodopa dose. There was no significant change in the dyskinesias. However, early-morning dystonia resolved in eight of 14 patients. Our findings suggest that L-CR is particularly effective in decreasing motor fluctuations, reducing nocturnal problems, and minimizing levodopa dose failures in PD.

Presented in part at the 44th annual meeting of the American Academy of Neurology, San Diego, CA, May 1992.

Address correspondence and reprint requests to Dr. Rajesh Pahwa, Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS 66160-7314.

Received June 12,1992. Accepted for publication in final form August 4, 1992.

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