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[5 years of experience in the treatment of parkinsonism with L-dopa and its combination with Ro4-4602].

Eighty-one Parkinsonic patients were treated with L-dopa alone and/or combined with Ro4-4602, during 27 to 60 months. The results are reported. 7.2% of the patients, who are still being treated, showed good, very good or excellent results. There was a relation between the duration of the illness and the degree of improvement, the most prolonged Parkinsonisms showed the least improvement. The 4:1 proportion of L-dopa and Ro4-4602 was more effective than the 3:2. Adding small amounts of L-dopa to the combinations improvement and secondary effects increased. No advantages were found using high combined dosages. The main secondary effects at the end of treatment were abnormal movements (45% of cases) and distonic attitudes (53%). Patients who stoped the medication showed less sustained improvement and a high degree of Parkinsonism. This reveals that Parkinson's disease continues to envolve in spite of the medication. The "long-term syndrome" includes the late decrease of effectiveness of the drugs and/or the increase of secondary effects.