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J Neurol Neurosurg Psychiatry. 2004 Dec;75(12):1672-7.
Mucuna pruriens in Parkinson's disease: a double blind clinical and
pharmacological study.



Katzenschlager R, Evans A, Manson A, Patsalos PN, Ratnaraj N, Watt H,
Timmermann L, Van der Giessen R, Lees AJ.

National Hospital for Neurology and Neurosurgery, London, UK.

BACKGROUND: The seed powder of the leguminous plant, Mucuna pruriens has
long been used in traditional Ayurvedic Indian medicine for diseases
including parkinsonism. We have assessed the clinical effects and levodopa
(L-dopa) pharmacokinetics following two different doses of mucuna
preparation and compared them with standard L-dopa/carbidopa (LD/CD).
METHODS: Eight Parkinson's disease patients with a short duration L-dopa
response and on period dyskinesias completed a randomised, controlled,
double blind crossover trial. Patients were challenged with single doses of
200/50 mg LD/CD, and 15 and 30 g of mucuna preparation in randomised order
at weekly intervals. L-dopa pharmacokinetics were determined, and Unified
Parkinson's Disease Rating Scale and tapping speed were obtained at baseline
and repeatedly during the 4 h following drug ingestion. Dyskinesias were
assessed using modified AIMS and Goetz scales. RESULTS: Compared with
standard LD/CD, the 30 g mucuna preparation led to a considerably faster
onset of effect (34.6 v 68.5 min; p = 0.021), reflected in shorter latencies
to peak L-dopa plasma concentrations. Mean on time was 21.9% (37 min) longer
with 30 g mucuna than with LD/CD (p = 0.021); peak L-dopa plasma
concentrations were 110% higher and the area under the plasma concentration
v time curve (area under curve) was 165.3% larger (p = 0.012). No
significant differences in dyskinesias or tolerability occurred.
CONCLUSIONS: The rapid onset of action and longer on time without
concomitant increase in dyskinesias on mucuna seed powder formulation
suggest that this natural source of L-dopa might possess advantages over
conventional L-dopa preparations in the long term management of PD.
Assessment of long term efficacy and tolerability in a randomised,
controlled study is warranted.

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