Treatment of Parkinson's disease with l-DOPA and an association l-DOPA plus a DOPA decarboxylase inhibitor

l-DOPA therapy of Parkinsonism by mouth, today universally accepted, may induce undesirable effects which can sometimes be of a certain severity. Gastrointestinal complaints and hypotension may be dependent from the dose of the drug, which can exert an irritating action on the gastric mucous, or may be due to a higher level of circulating catecholamines. Involuntary movements depend from a stimulating action on certain mesencephalic-diencephalic pathways. Pharmacologists have therefore tried to obviate these inconvenients, through the introduction of the peripheral DOPA-decarboxylase inhibitors; the administration of these drugs led to the following results in the animal: reduction of dosage consequent to a more sustained blood level of l-DOPA, reduction of side effects, possible decrease of involuntary movements. The data are obtained comparing two groups of patients: the first group (60 cases) treated with l-DOPA per os, the second group (24 cases) treated with an association of l-DOPA + decarboxylase inhibitor (Ro 8-0576, each capsule containing l-DOPA, 200 mg and Ro 4-4602, 50 mg). According to the results achieved, it can be stated that: 1. Ro 8-0576 gives a lower incidence of side effects; 2. the latency to achieve the therapeutic effect is shorter with Ro 8-0576; 3. this drug allows a greater benefit on tremor (55% with Ro 8-0576, 48% with l-DOPA only). Furthermore, the chief parkinsoniam symptoms (tremor, rigidity, akinesia) are better influenced.