Modification of L-dopa therapy of Parkinsonism by alpha-methyldopa hydrazine (MK-486)
Yahr, M.D.; Duvoisin, R.C.; Mendoza, M.R.; Schear, M.J.; Barrett, R.E.
Transactions of the American Neurological Association 96: 55-58
1971
ISSN/ISBN: 0065-9479 PMID: 5159129 Document Number: 5503
The average daily dose of levodopa required to achieve a comparable result is much smaller - only 25% of the daily dose is required. Dosing schedules are simplified to three or four doses compared to six to ten with dopa alone. A much more rapid clinical response occurs; it takes only a few days versus several months to achieve the maximal benefit. In this series, beneficial effects were evident within a day, and full benefits within one week. In some instances a dramatic reversal of parkinsonism occurred following the first combined dose of L-Dopa and MK-486. More effective responses are occasionally seen with the combined regimen. In two patients not responsive to maximum dosage of L-Dopa, one responded when MK-486 was added. A decreased degree of responsiveness was restored in eight patients by its addition. The most salutory effect was evident in cases with diurnal variations. In 11 of 16 patients this was modified to a tolerable level with a more uniform therapeutic response. However, five patients with rather severe "on-off" responses were not appreciably improved. Side-effects were appreciably altered with the incidence of nausea and vomiting curtailed and hypotension not as prominent. However, abnormal involuntary movements occurred with equal frequency, as did behavioral disorders. In summary, the combination of levodopa with alphα-methyldopa hydrazine is an effective, rapid, and efficient means of reversing the parkinsonian state. It does not, however, completely alleviate the shortcomings of L-Dopa since many of the limiting side-effects occur with equal frequency.
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