A Double Blind Study of 1-Dopa Treatment in Parkinson's Disease1

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Abstract
A controlled double blind trial of the therapeutic effect of 1 -dopa on Parkinsonian symptoms was made with 36 patients. The therapeutic effect was recorded 1/2 hr. and 6 hr. after the intravenous injection of 1.5 mg/kg b. w. [body weight] of 1-dopa or a corresponding amount of physiologic saline. The amount of rigidity and tremor was scored with a 5-point scale, and the tremor also with a tremor-recording transducer. Akinesia was assessed with various tests and by measuring mobility and initiation and total reaction time. 1-Dopa treatment was not superior to placebo for rigidity, tremor or akinesia. The patients became significantly more agile 6 hr. after 1-dopa treatment, but did not do so after placebo. Nor were the differences in general between the stereotactically operated and non-operated patients, except that the total reaction time of the non-operated patients improved significantly after 1-dopa treatment but not that of the operated patients. The improvement of the performance tests was more significant in the operated patients than in the non-operated ones. The commonest side effect of 1-dopa treatment, nausea, occurred in a half of the patients an average of 5-15 min. after the injection. Five patients experienced relatively severe hypotension. The value of 1 -dopa is questionable in the treatment of Parkinsonian patients. The necessity of a controlled double blind trial in the assessment of the therapeutic response to pharmacological agents in Parkinsonian patients was emphasized.

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