INTRODUCTION: Epidemiologic studies consistently find an inverse association between caffeine use and PD. Numerous explanations exist, but are difficult to evaluate as caffeine's symptomatic effect and tolerability in PD are unknown. PATIENTS AND METHODS: We designed an open-label, 6-week dose-escalation study of caffeine to establish dose tolerability and evaluate potential motor/nonmotor benefits. Caffeine was started at 200 mg daily and was increased to a maximum of 1,000 mg. RESULTS: Of 25 subjects, 20 tolerated 200 mg, 17 tolerated 400 mg, 7 tolerated 800 mg, and 3 tolerated 1,000 mg. The most common adverse events were gastrointestinal discomfort, anxiety, and worsening/emerging tremor. At 400 mg daily, we found potential improvements in motor manifestations and somnolence (UPDRS III: -4.5 ± 4.6, P = 0.003; Epworth: -2.0 ± 3.0, P = 0.015). CONCLUSION: Maximum dose tolerability for caffeine in PD appears to be 100 to 200 mg BID. We found pilot preliminary evidence that caffeine may improve some motor and nonmotor aspects of PD, which must be confirmed in longer term, placebo-controlled, clinical trials.
INTRODUCTION: Epidemiologic studies consistently find an inverse association between caffeine use and PD. Numerous explanations exist, but are difficult to evaluate as caffeine's symptomatic effect and tolerability in PD are unknown. PATIENTS AND METHODS: We designed an open-label, 6-week dose-escalation study of caffeine to establish dose tolerability and evaluate potential motor/nonmotor benefits. Caffeine was started at 200 mg daily and was increased to a maximum of 1,000 mg. RESULTS: Of 25 subjects, 20 tolerated 200 mg, 17 tolerated 400 mg, 7 tolerated 800 mg, and 3 tolerated 1,000 mg. The most common adverse events were gastrointestinal discomfort, anxiety, and worsening/emerging tremor. At 400 mg daily, we found potential improvements in motor manifestations and somnolence (UPDRS III: -4.5 ± 4.6, P = 0.003; Epworth: -2.0 ± 3.0, P = 0.015). CONCLUSION: Maximum dose tolerability for caffeine in PD appears to be 100 to 200 mg BID. We found pilot preliminary evidence that caffeine may improve some motor and nonmotor aspects of PD, which must be confirmed in longer term, placebo-controlled, clinical trials.
Authors: Anne-Marie A Wills; Shirley Eberly; Marsha Tennis; Anthony E Lang; Susan Messing; Daniel Togasaki; Caroline M Tanner; Cornelia Kamp; Jiang-Fan Chen; David Oakes; Michael P McDermott; Michael A Schwarzschild Journal: Mov Disord Date: 2013-01-21 Impact factor: 10.338
Authors: Ronald B Postuma; Anthony E Lang; Renato P Munhoz; Katia Charland; Amelie Pelletier; Mariana Moscovich; Luciane Filla; Debora Zanatta; Silvia Rios Romenets; Robert Altman; Rosa Chuang; Binit Shah Journal: Neurology Date: 2012-08-01 Impact factor: 9.910
Authors: Ronald B Postuma; Julius Anang; Amelie Pelletier; Lawrence Joseph; Mariana Moscovich; David Grimes; Sarah Furtado; Renato P Munhoz; Silke Appel-Cresswell; Adriana Moro; Andrew Borys; Douglas Hobson; Anthony E Lang Journal: Neurology Date: 2017-09-27 Impact factor: 9.910