A comparison of Madopar CR and standard Madopar in the treatment of nocturnal and early-morning disability in Parkinson's disease. The U.K. Madopar CR Study Group.

In a double-blind, crossover study, 103 patients with Parkinson's disease and nocturnal and/or early-morning disabilities took a bedtime dose of either Madopar CR (controlled-release levodopa plus benserazide) or standard Madopar, in addition to their usual daytime levodopa regimen. The mean optimum dosages were as follows: Madopar CR, 2.4 125 mg capsules; standard Madopar, 2.2 125 mg capsules. Assessment by daily patient diary and the doctor's record showed that nocturnal and early-morning disability was reduced by both treatments compared with at the start of the study, the difference being statistically significant. Improvement occurred in a similar number of patients when taking Madopar CR or standard Madopar (nocturnal disability improved in 61% on Madopar CR, and 57% on standard Madopar: early-morning disability improved in 46% on Madopar CR, and 44% on standard Madopar) and the percentage of patients wishing to continue on each treatment was also similar (64% on Madopar CR, and 55% on standard Madopar). However, in two-thirds of all cases, both doctor and patient felt that there was a difference between the treatments. Both Madopar CR and standard Madopar were of benefit to patients with nocturnal disability and, to a lesser extent, to those with early-morning problems. However, some patients responded better to Madopar CR and some to standard Madopar.