ORAL L‐DOPA TREATMENT OF PARKINSONISM

. Six parkinsonian patients have been treated with increasing oral doses of L-3,4-dihydroxyphenylalanine (L-dopa) up to 8.25 g/d. Previous anticholinergic therapy had been discontinued. Four of the patients were remarkably improved; the best effect was observed on the akinesia. The L-dopa treatment was discontinued in two of the patients as they were not markedly improved but displayed considerable side-effects. Nausea and occasionally vomiting were observed in most patients. Hyperkinesia occurred at the high dose levels. Their mood was elevated but mental disturbance developed in four of the patients. In two of these patients the disturbance disappeared after reduction of the dose. Most of the L-dopa was metabolized to dopamine outside the brain. Large diurnal variations of the dopa level in blood were observed in agreement with similar variations in the therapeutic effect.