[Clinical experience in switching patients from standard levodopa to a controlled-release levodopa]

We switched 50 patients with Parkinson's disease and motor fluctuations from standard levodopa (L-S) to controlled-release carbidopa/levodopa (L-CR). Ten (20%) patients stopped treatment due to adverse events. Data on the 40 patients who completed 6 months of treatment were analyzed. Parkinsonian assessments were performed using the Unified Parkinson's Disease Rating scale (UPDRS) and a nocturnal rating scale. During treatment with L-CR the total daily dose of levodopa increased and the number of daily doses decreased. After changing to L-CR, patients also experienced significant improvement on sub-scales II and III of UPDRS and on the Schwab and England and nocturnal mobility scales. The proportion of "off" time decreased but the duration and severity of dyskinesias increased. Most of the patients who dropped out of the L-CR group had already experienced some type of adverse event during treatment with L-S. At the end of the study, the number of patients preferring L-CR was significantly higher than the number preferring L-S.