Association of l-DOPA with recovery following Ayurveda medication in Parkinson’s disease

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Abstract

Ayurveda, the Indian system of traditional medicine, uses a concoction of several spices, herbs and minerals for the treatment of diseases. In a clinical prospective study we have evaluated the efficacy of Ayurveda treatment (a concoction in cow’s milk of powdered Mucuna pruriens and Hyoscyamus reticulatus seeds and Withania somnifera and Sida cordifolia roots) in 18 clinically diagnosed (with a mean Hoen and Yahr value of 2.22) parkinsonian patients. As per Ayurveda principles, 13 patients underwent both cleansing (for 28 days) and palliative therapy (56 days), 5 patients underwent palliative therapy alone (84 days). Only the former group showed significant improvement in activities of daily living (ADL) and on motor examination as per UPDRS rating. Symptomatically, they exhibited better response in tremor, bradykinesia, stiffness and cramps as compared to the latter group. Excessive salivation worsened in both the groups. Analyses of powdered samples in milk, as administered in patients, revealed about 200 mg of l-DOPA per dose. The study establishes the necessity of cleansing therapy in Ayurveda medication prior to palliative therapy. It also reveals contribution of l-DOPA in the recovery as observed in Parkinson’ disease following Ayurveda medication.

Introduction

The ancient medical science being practised in India from the Vedic times (1500–1000 BC), “Ayurveda” (‘knowledge concerning longevity’), uses plant tissues as medicine [1]. Based on Ayurveda principles given in “Charakasamhitha”, the classical text in Ayurveda, a concoction in cow’s milk of powdered Mucuna pruriens and Hyoscyamus reticulatus seeds and Withania somnifera and Sida cordifolia roots is prescribed for treating Parkinson’s disease [2]. M. pruriens is reported to contain l-DOPA as one of its constituents [3]. H. reticulatus, W. somnifera and S. cordifolia contain a number of neuroactive constituents like hyoscyamine, somniferin, ephedrine, etc. [2], [3]. Commercial preparations (HP-200; Zandu Pharmaceuticals, Bombay) of M. pruriens are available in India for the treatment of Parkinson’s disease. In this clinical prospective study, we have evaluated the effects of Ayurveda medication on the symptoms and signs in 18 patients of Parkinson’ disease. The study also compared the effects, if any, of cleansing and palliative therapy as prescribed in ancient text books as compared to that of palliative therapy alone. Contents of l-DOPA were also analysed in the seeds and roots of the plants used as medicine.

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Materials and methods

Clinically diagnosed [4] Parkinson’s disease in-patients of the Govt. Ayurveda hospital were recruited to the study after obtaining informed consent. The institutes’ respective Ethical committees approved the study. The mean age of the patients was 59.8±5.8 (S.D.), disease duration was 3±2.6 years, male to female ratio was 5:4, and their mean Hoen and Yahr score in “off” condition was 2.22±0.73. All medications, including herbal preparations, were discontinued 15 days prior to the initiation of

Results

Tremor and bradykinesia were present in 100%, and stiffness and cramp-like pain respectively in 15.4% and 61.6% patients who underwent cleansing and palliative therapy. These symptoms were improved in 61.5, 69.2, 100 and 75% patients following Ayurveda treatment. The patients, who underwent palliative therapy alone had stiffness (60%), tremor (80%), bradykinesia (100%) and cramps (40%); and 33.3, 50, 40 and 100% of these patients revealed improvement. Other symptoms like loss of blinking of

Discussion

The UPDRS show improvement in the condition of the patients who underwent proper Ayurveda treatment. Our results show improvement in symptoms like stiffness, tremor, bradykinesia and cramp-like pain in lower limbs as well as in objective tests in patients who underwent both eliminative (“panchakarma”) and palliative therapy indicating the effectiveness of proper Ayurveda treatment in Parkinson’s disease. The cleansing therapy administered in patients such as purgation and enema could have

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