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The long-duration response to L-dopa in the treatment of early PD. OBJECTIVE: To investigate the long-duration response (LDR) to L-dopa resulting from different regimens of L-dopa. BACKGROUND: In clinical practice, L-dopa is usually administered without considering the LDR due to the drug. Moreover, it has not been established whether in early PD a multiple daily intake of small doses of L-dopa may induce a sustained LDR. METHODS: 24 patients with early PD underwent a double-blind, crossover trial, comparing 3 different 15-day treatment periods with L-dopa: treatment A (250 mg every 24 hours); treatment B (250 mg every 8 hours); and treatment C (125 mg every 8 hours). After completion, 20 patients underwent a subsequent open-label randomized trial with prolonged treatments (250 mg every 24 hours or 125 mg every 8 hours) up to 3 months. LDR was measured at the end of each treatment. RESULTS: All patients achieved a sustained LDR after treatments A and B, whereas only 17% of patients reached a sustained LDR after treatment C. Overall, the LDRs resulting from treatments A and B had similar magnitude and were larger than the LDR deriving from treatment C. After 3 months of prolonged treatments, only three of 10 patients treated with 125 mg every 8 hours increased their LDR, whereas all 10 patients treated with 250 mg every 24 hours had a maximal and stable LDR. CONCLUSIONS: Sustained LDR to L-dopa is dependent on the amount of the single doses of the drug. A regimen scheduling small, divided doses during the day, as done in clinical practice, is a questionable therapy for the achievement of a sustained LDR. Neurology 2000 May 23;54(10):1910-5 Zappia M, Oliveri RL, Bosco D, Nicoletti G, Branca D, Caracciolo M, Napoli ID, Gambardella A, Quattrone A Institute of Neurology, University of Catanzaro, Italy. PMID: 10822428, UI: 20284127 janet paterson 53 now / 41 dx / 37 onset 613 256 8340 / PO Box 171 Almonte Ontario K0A 1A0 Canada visit my website "a new voice" at: "http://www.geocities.com/janet313/"