The Sydney Multicentre Study of Parkinson's disease: a randomised, prospective five year study comparing low dose bromocriptine with low dose levodopa-carbidopa.
149 previously untreated patients with Parkinson's disease were recruited over a three year period and randomly allocated to either low dose levodopa-carbidopa (< or = 600/150 mg/day) or low dose bromocriptine (< or = 30 mg/day). A five year follow up is reported on the 126 patients who completed the dose titration and who have not developed features of atypical Parkinsonism. Levodopa-carbidopa in low dosage adequately controlled symptoms in most patients and delayed the appearance of dyskinesia and end of dose failure for about two years longer than conventional doses. Only a few patients could be managed for more than one year on low dose bromocriptine alone; these patients had mild disease and asymmetric signs. Patients randomised to bromocriptine did not develop dyskinesia or troublesome end of dose failure until levodopa-carbidopa was added. The prevalence of dyskinesia in this group was lower than in patients given levodopa-carbidopa alone. The prevalence of end of dose failure was similar in the two randomisation groups once levodopa was introduced.
Hely
M A
MA
Neurology Department, Westmead Hospital, Sydney, Australia.
Morris
J G
JG
Reid
W G
WG
O'Sullivan
D J
DJ
Williamson
P M
PM
Rail
D
D
Broe
G A
GA
Margrie
S
S
D000328:Adult; D000368:Aged; D001971:Bromocriptine / Q000627:therapeutic use*; D002230:Carbidopa / Q000627:therapeutic use*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000453:epidemiology / Q000209:etiology; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy*; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D017211:Treatment Failure
D004338:Drug Combinations; D001971:Bromocriptine; D007980:Levodopa; D002230:Carbidopa