Clinical Efficacy of a Liquid Formulation of Levodopa (Madopar Dispersible) in Reversing Afternoon “Off” Periods in Parkinson's Disease

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Summary:Many parkinsonian patients experience “off” periods in the afternoon and frequently report that individual doses of levodopa fail to be effective. This study was designed to evaluate the clinical efficacy of a liquid for-mulation of levodopa, Madopar Dispersible (100 mg of levodopa + 25 mg of benserazide), in reversing afternoon “off” periods. Thirteen fluctuating patients, seven women and six men aged 48-72 years (mean 60.6), were included in this open study. All patients were treated with standard levodopa and experienced afternoon “off” periods (mean, 226 min). The levodopa dose judged to be inefficient in the afternoon was replaced by a similar dose of Madopar Dispersible (mean, 3:00 p.m.). Ten patients improved: duration of “off” period was 177 min (60-240 min) with standard levodopa, and 53 min (20-135 min) with Madopar Dispersible (p < 0.001). The latency to “on” was 24 min (10-45 min) and duration of the “on” was 117 min (60-210 min). These results suggest that failure of absorption of levodopa might explain some of the afternoon “off” periods and that Madopar Dispersible may be a simple and reliable tool for treatment of such periods of akinesia.

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