Oral pulse levodopa therapy in mild Parkinson's disease.

Chronic levodopa administration in Parkinson's disease (PD) is associated with long-term motor side effects. To reduce the cumulative amount of levodopa intake by patients with mild PD, we investigated the clinical efficacy of short periods of treatment with levodopa scheduled at different daily dosages and administered in a conventional design (ie, three times a day) compared with a standard oral dose of the drug administered once every 3 days. The latter dose regimen, designated "oral pulse levodopa therapy" (OPLT), allowed us to obtain a clinical response comparable to that obtained by conventional treatments that involve cumulative daily levodopa dosages up to seven times higher than OPLT. The clinical efficacy of OPLT could be related to the preservation of compensatory mechanisms in Parkinson's disease that are masked by conventional intermittent replacement therapy.