RT Journal Article SR Electronic T1 Mucuna pruriens in Parkinson’s disease: a double blind clinical and pharmacological study JF Journal of Neurology, Neurosurgery & Psychiatry JO J Neurol Neurosurg Psychiatry FD BMJ Publishing Group Ltd SP 1672 OP 1677 DO 10.1136/jnnp.2003.028761 VO 75 IS 12 A1 R Katzenschlager A1 A Evans A1 A Manson A1 P N Patsalos A1 N Ratnaraj A1 H Watt A1 L Timmermann A1 R Van der Giessen A1 A J Lees YR 2004 UL http://jnnp.bmj.com/content/75/12/1672.abstract AB Background: The seed powder of the leguminous plant, Mucuna pruriens has long been used in traditional Ayurvedic Indian medicine for diseases including parkinsonism. We have assessed the clinical effects and levodopa (l-dopa) pharmacokinetics following two different doses of mucuna preparation and compared them with standard l-dopa/carbidopa (LD/CD). Methods: Eight Parkinson’s disease patients with a short duration l-dopa response and on period dyskinesias completed a randomised, controlled, double blind crossover trial. Patients were challenged with single doses of 200/50 mg LD/CD, and 15 and 30 g of mucuna preparation in randomised order at weekly intervals. l-Dopa pharmacokinetics were determined, and Unified Parkinson’s Disease Rating Scale and tapping speed were obtained at baseline and repeatedly during the 4 h following drug ingestion. Dyskinesias were assessed using modified AIMS and Goetz scales. Results: Compared with standard LD/CD, the 30 g mucuna preparation led to a considerably faster onset of effect (34.6 v 68.5 min; p = 0.021), reflected in shorter latencies to peak l-dopa plasma concentrations. Mean on time was 21.9% (37 min) longer with 30 g mucuna than with LD/CD (p = 0.021); peak l-dopa plasma concentrations were 110% higher and the area under the plasma concentration v time curve (area under curve) was 165.3% larger (p = 0.012). No significant differences in dyskinesias or tolerability occurred. Conclusions: The rapid onset of action and longer on time without concomitant increase in dyskinesias on mucuna seed powder formulation suggest that this natural source of l-dopa might possess advantages over conventional l-dopa preparations in the long term management of PD. Assessment of long term efficacy and tolerability in a randomised, controlled study is warranted.