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© 1973 Oxford University Press

research-article

L-DOPA* THERAPY IN ELDERLY PATIENTS WITH PARKINSONISM

R. L. G. SUTCLIFFE

St Edmund's Hospital Northampton

The effect of laevo-dihydroxyphenylalanine (L-DOPA*) on Parkinsonism in 50 patients, average age 70, and side-effects were studied. All patients were seen personally and carefully selected. Those with myocardial ischaemia, arrhythmia, or psychosis were excluded. Small L-DOPA increments were prescribed commencing with 125 mg twice daily. Clinical features of Parkinsonism and side-effects of therapy were observed and scored regularly for 24 months. There was general score improvement; before treatment scores lay between 19 and 8: at 12 weeks between 11 and 2. There was minimal improvement subsequently to 24 months. Functional improvement was observed in 75 per cent of patients. Nine of the 23 hospital patients returned home markedly better, three died in the first three months of therapy, one of toxaemia due to congestive cardiac failure, one of bronchopneumonia and one of coronary thrombosis possibly associated with increased activity due to ‘successful’ therapy. Four patients died between 9 and 12 months of unrelated causes. It is concluded that the drug is effective in the elderly and side-effects were noted to be rather less than in some series, perhaps because of the very cautious increase in dosage.


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