The Sydney Multicentre Study of Parkinson's disease: a randomised, prospective five year study comparing low dose bromocriptine with low dose levodopa-carbidopa

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 57; no. 8; pp. 903 - 910
• Main Authors: Hely, M A, Morris, J G, Reid, W G, O'Sullivan, D J, Williamson, P M, Rail, D, Broe, G A, Margrie, S
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.08.1994; BMJ; BMJ Publishing Group LTD
• Subjects: Adult; Aged; Anticonvulsants. Antiepileptics. Antiparkinson agents; Biological and medical sciences; Bromocriptine - therapeutic use; Carbidopa - therapeutic use; Double-Blind Method; Drug Combinations; Female; Follow-Up Studies; Humans; Levodopa - therapeutic use; Male; Medical sciences; Middle Aged; Movement Disorders - epidemiology; Movement Disorders - etiology; Neuropharmacology; Parkinson Disease - complications; Parkinson Disease - drug therapy; Pharmacology. Drug treatments; Prevalence; Prospective Studies; Severity of Illness Index; Survival Analysis; Treatment Failure; Australia; Oceania; Bromocryptine; Human; Nervous system diseases; Agonist; Dopamine; Low dose; Multicenter study; Parkinson disease; Antiparkinson agent; Cerebral disorder; Chemotherapy; Treatment; Central nervous system disease; Degenerative disease; Levodopa; Comparative study; Extrapyramidal syndrome
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.57.8.903

149 previously untreated patients with Parkinson's disease were recruited over a three year period and randomly allocated to either low dose levodopa-carbidopa (< or = 600/150 mg/day) or low dose bromocriptine (< or = 30 mg/day). A five year follow up is reported on the 126 patients who completed the dose titration and who have not developed features of atypical Parkinsonism. Levodopa-carbidopa in low dosage adequately controlled symptoms in most patients and delayed the appearance of dyskinesia and end of dose failure for about two years longer than conventional doses. Only a few patients could be managed for more than one year on low dose bromocriptine alone; these patients had mild disease and asymmetric signs. Patients randomised to bromocriptine did not develop dyskinesia or troublesome end of dose failure until levodopa-carbidopa was added. The prevalence of dyskinesia in this group was lower than in patients given levodopa-carbidopa alone. The prevalence of end of dose failure was similar in the two randomisation groups once levodopa was introduced.