Research - Mucuna pruriens
Mucuna pruriens in Parkinson’s disease: a double blind clinical and pharmacological study
R Katzenschlager, A Evans, A Manson, P N Patsalos, N Ratnaraj, H Watt, L Timmermann,R Van der Giessen, A J Lees
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 on set of effect (34.6v68.5 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-dopaplasma concentrations were 110% higher and the area under the plasma concentration vtime 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
Source : J Neurol Neurosurg Psychiatry
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