[Treatment of Parkinson disease with levodopa depot preparations]

The majority of parkinsonian patients on long-term treatment with levodopa develop fluctuations in motor performance. Several of the features of long-term levodopa treatment seem to be associated with levodopa concentrations in the plasma. In order to overcome the dose-related clinical fluctuations, sustained or controlled-release oral tablets have been developed to achieve more stable plasma concentrations of the drug. This paper describes a Norwegian multi-centre study of Sinemet CR in 56 patients with mild to moderate parkinsonism. After 24 weeks on Sinemet CR the performance of 40 patients was evaluated as improved, i.e. better than when they were treated with standard levodopa. Patients with mild disease or with no motor fluctuations experienced similar clinical benefit from controlled-release levodopa as the more advanced parkinsonian patients. The authors also discuss the advantages and problems of controlled-release levodopa in parkinsonian patients in general.