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Richard D. Sweet, MD; Fletcher H. McDowell, MD; Claude G. Wasterlain, MD; Peter H. Stern, MD

Arch Neurol. 1975;32(8):560-563.

Abstract
Irregularities in motor response after continuing levodopa therapy of Parkinson disease (the "on-off effect") were assessed with the addition of l--methydopa hydrazine (carbidopa) in a doubleblind study. Thirteen of 20 patients improved while receiving carbidopa and levodopa while only four of 17 patients improved while receiving placebo and levodopa. Twenty-three of 37 patients improved in a subsequent non-blind trial of carbidopa plus levodopa.

Improvement was not dependent on an increase in dose or frequency of levodopa administration. Adverse effects included dyskinesia, imbalance, and confusion; nausea was eliminated. One patient died of glomerulonephritis that predated the drug trial, but worsened progressively during and after it. Carbidopa's suppression of the "on-off effect" suggests that extracerebral factors may be important in this phenomenon.

Author Affiliations
From the Department of Neurology, Cornell University Medical College, New York.

Footnotes
Accepted for publication Oct 14, 1974.

Reprint requests to Department of Neurology, Cornell University Medical College, 1300 York Ave, New York, NY 10021 (Dr. Sweet).

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ABSTRACT