Oscillations in performance in levodopa-treated parkinsonians: treatment with bromocriptine and L-deprenyl

Fluctuations in performance in levodopa-treated Parkinsonians pose frequent and difficult problems of managment. Controlled trials with two recently introduced drugs, bromocriptine and L-deprenyl, have been performed in an attempt to clarify their use in Parkinsonian oscillations. Bromocriptine, partially substituted for levodopa, was helpful in 4 of 6 patients with early morning dystonia, but did not benefit 9 patients with end-of-dose deterioration and 5 patients with "on-off changes. L-Deprenyl 10mg daily gave substantial benefit to 19 of 39 patients with end-of-dose deterioration, but to only 1 of 10 patients with "on-off' phenomena. Neither L-deprenyl nor bromocriptine helped patients disabled by freezing episodes or levodopa-induced involuntary movements.