title: The Sydney Multicentre Study of Parkinson's disease: a randomised, prospective five year study comparing low dose bromocriptine with low dose levodopa-carbidopa.
abstract: 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.
authors.affiliation: Neurology Department, Westmead Hospital, Sydney, Australia.
authors.forename: M A
authors.initials: MA
authors.lastname: Hely
authors.forename: J G
authors.initials: JG
authors.lastname: Morris
authors.forename: W G
authors.initials: WG
authors.lastname: Reid
authors.forename: D J
authors.initials: DJ
authors.lastname: O'Sullivan
authors.forename: P M
authors.initials: PM
authors.lastname: Williamson
authors.forename: D
authors.initials: D
authors.lastname: Rail
authors.forename: G A
authors.initials: GA
authors.lastname: Broe
authors.forename: S
authors.initials: S
authors.lastname: Margrie
mesh_terms: 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
chemical_list: D004338:Drug Combinations; D001971:Bromocriptine; D007980:Levodopa; D002230:Carbidopa