Five Years' Treatment of Parkinson's Disease with Levodopa

One hundred patients with Parkinson's disease, who started taking levodopa before the end of 1968, have been assessed after 5 years. Forty-seven patients are still being followed on levodopa, and half of them are at least 25% better than at their pretreatment evaluation. However, the average functional rating is returning toward baseline from its remarkable improvement at 1/2 to 2 years. Abnormal involuntary movements, rapid oscillations in motor performance, postural instability, and dementia have become the major adverse effects. Thirty-two of the 100 patients have died. Life-table analysis shows an excess mortality of 1.9 compared with the U.S. population, a figure that is lower than the 2.9 reported before levodopa's use. Despite its inability to cure Parkinson's disease, levodopa provides symptomatic relief for a prolonged time and it remains the single most effective medication for the illness.