Substitution of standard Madopar by Madopar HBS in parkinsonians with fluctuations.

Fourteen parkinsonian patients, 10 of them showing severe and long-standing 'on-off' effects and 4 'end-of-dose impairment', received Madopar HBS instead of standard Madopar. At the end of the dosage adaptation phase (9 weeks) most patients improved; in patients with 'on-off' phenomenon, parkinsonism became less severe, on periods were longer, and fluctuations decrease; end-of-dose impairment resolved in 4 patients. However, a longer delay in the onset of the therapeutic effect was observed after the first daily drug intake in those patients still showing severe early-morning parkinsonism. With Madopar HBS, L-dopa dosage was increased by 116%. In spite of a greater dopaminergic effect, dyskinesias were reduced, and dystonias became less marked or even disappeared.