[Biochemical evaluation of the effectiveness of antiparkinson preparations containing L-DOPA].

The content of adrenaline, noradrenaline, DOPA, and dopamine in the daily portion of the urine was examined in 26 patients with parkinsonism who took for many years L-DOPA which was then replaced by the drugs synemet and nacom containing, in addition to DOPA, a specific inhibitor of peripheral DOPA-decarboxylase (MK-486). As control 10 healthy subjects and 37 non-treated parkinsonic patients were examined. Advantages of the drugs synemet and nacom over L-DOPA are noted. These advantages manifest themselves in the form of favourable changes of the mediator balance in the presence of positive clinical effect and possibility of reducing the L-DOPA dose by administering those drugs. No substantial changes of biochemical parameters were revealed in the patients treated with synemet and nacom. A correlation between the hypersecretion of adrenaline and noradrenaline in the patients with parkinsonism treated with L-DOPA-containing drugs and the development of cerebral side effects (hyperkinesias, psychic disturbances) was discovered. Possible mechanisms of the development of the cerebral side effects in patients treated with DOPA-containing drugs are discussed, and necessity of combined therapy is stressed.