Caffeine in Parkinson's disease: A pilot open-label, dose-escalation study
Introduction: Epidemiologic studies consistently find an inverse association between caffeine use and PD. Numerous explanations exist, but are difficult to evaluate as caffeine's symptomatic effect and tolerability in PD are unknown. Patients and Methods: We designed an open‐label, 6‐week dose‐...
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| Veröffentlicht in: | Movement disorders 2011-11, Vol.26 (13), p.2427-2431 |
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| creator | Altman, Robert D. Lang, Anthony E. Postuma, Ronald B. |
| description | Introduction:
Epidemiologic studies consistently find an inverse association between caffeine use and PD. Numerous explanations exist, but are difficult to evaluate as caffeine's symptomatic effect and tolerability in PD are unknown.
Patients and Methods:
We designed an open‐label, 6‐week dose‐escalation study of caffeine to establish dose tolerability and evaluate potential motor/nonmotor benefits. Caffeine was started at 200 mg daily and was increased to a maximum of 1,000 mg.
Results:
Of 25 subjects, 20 tolerated 200 mg, 17 tolerated 400 mg, 7 tolerated 800 mg, and 3 tolerated 1,000 mg. The most common adverse events were gastrointestinal discomfort, anxiety, and worsening/emerging tremor. At 400 mg daily, we found potential improvements in motor manifestations and somnolence (UPDRS III: −4.5 ± 4.6, P = 0.003; Epworth: −2.0 ± 3.0, P = 0.015).
Conclusion:
Maximum dose tolerability for caffeine in PD appears to be 100 to 200 mg BID. We found pilot preliminary evidence that caffeine may improve some motor and nonmotor aspects of PD, which must be confirmed in longer term, placebo‐controlled, clinical trials. © 2011 Movement Disorder Society |
| doi_str_mv | 10.1002/mds.23873 |
| format | Article |
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Epidemiologic studies consistently find an inverse association between caffeine use and PD. Numerous explanations exist, but are difficult to evaluate as caffeine's symptomatic effect and tolerability in PD are unknown.
Patients and Methods:
We designed an open‐label, 6‐week dose‐escalation study of caffeine to establish dose tolerability and evaluate potential motor/nonmotor benefits. Caffeine was started at 200 mg daily and was increased to a maximum of 1,000 mg.
Results:
Of 25 subjects, 20 tolerated 200 mg, 17 tolerated 400 mg, 7 tolerated 800 mg, and 3 tolerated 1,000 mg. The most common adverse events were gastrointestinal discomfort, anxiety, and worsening/emerging tremor. At 400 mg daily, we found potential improvements in motor manifestations and somnolence (UPDRS III: −4.5 ± 4.6, P = 0.003; Epworth: −2.0 ± 3.0, P = 0.015).
Conclusion:
Maximum dose tolerability for caffeine in PD appears to be 100 to 200 mg BID. We found pilot preliminary evidence that caffeine may improve some motor and nonmotor aspects of PD, which must be confirmed in longer term, placebo‐controlled, clinical trials. © 2011 Movement Disorder Society</description><identifier>ISSN: 0885-3185</identifier><identifier>EISSN: 1531-8257</identifier><identifier>DOI: 10.1002/mds.23873</identifier><identifier>PMID: 21953603</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; caffeine ; Caffeine - administration & dosage ; Caffeine - adverse effects ; clinical trials ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Dose-Response Relationship, Drug ; Humans ; Medical sciences ; Middle Aged ; Neurology ; neuroprotection ; Parkinson Disease - drug therapy ; Parkinson Disease - physiopathology ; Parkinson's disease ; Pilot Projects ; Psychiatric Status Rating Scales ; Severity of Illness Index ; Treatment Outcome</subject><ispartof>Movement disorders, 2011-11, Vol.26 (13), p.2427-2431</ispartof><rights>Copyright © 2011 Movement Disorder Society</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 Movement Disorder Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4583-5ceee926220a675abdb6142422ceec0674d02838e439ade7b27df2c63bf3d573</citedby><cites>FETCH-LOGICAL-c4583-5ceee926220a675abdb6142422ceec0674d02838e439ade7b27df2c63bf3d573</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fmds.23873$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmds.23873$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25262496$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21953603$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Altman, Robert D.</creatorcontrib><creatorcontrib>Lang, Anthony E.</creatorcontrib><creatorcontrib>Postuma, Ronald B.</creatorcontrib><title>Caffeine in Parkinson's disease: A pilot open-label, dose-escalation study</title><title>Movement disorders</title><addtitle>Mov. Disord</addtitle><description>Introduction:
Epidemiologic studies consistently find an inverse association between caffeine use and PD. Numerous explanations exist, but are difficult to evaluate as caffeine's symptomatic effect and tolerability in PD are unknown.
Patients and Methods:
We designed an open‐label, 6‐week dose‐escalation study of caffeine to establish dose tolerability and evaluate potential motor/nonmotor benefits. Caffeine was started at 200 mg daily and was increased to a maximum of 1,000 mg.
Results:
Of 25 subjects, 20 tolerated 200 mg, 17 tolerated 400 mg, 7 tolerated 800 mg, and 3 tolerated 1,000 mg. The most common adverse events were gastrointestinal discomfort, anxiety, and worsening/emerging tremor. At 400 mg daily, we found potential improvements in motor manifestations and somnolence (UPDRS III: −4.5 ± 4.6, P = 0.003; Epworth: −2.0 ± 3.0, P = 0.015).
Conclusion:
Maximum dose tolerability for caffeine in PD appears to be 100 to 200 mg BID. We found pilot preliminary evidence that caffeine may improve some motor and nonmotor aspects of PD, which must be confirmed in longer term, placebo‐controlled, clinical trials. © 2011 Movement Disorder Society</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>caffeine</subject><subject>Caffeine - administration & dosage</subject><subject>Caffeine - adverse effects</subject><subject>clinical trials</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Dose-Response Relationship, Drug</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>neuroprotection</subject><subject>Parkinson Disease - drug therapy</subject><subject>Parkinson Disease - physiopathology</subject><subject>Parkinson's disease</subject><subject>Pilot Projects</subject><subject>Psychiatric Status Rating Scales</subject><subject>Severity of Illness Index</subject><subject>Treatment Outcome</subject><issn>0885-3185</issn><issn>1531-8257</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUlLxEAQhRtRdFwO_gHJRUQw2kt6iTcdd1xxQPHSdNIVaM0kYyqDzr8344x68lSH-t571CtCNhndZ5Tyg6HHfS6MFgukx6RgseFSL5IeNUbGghm5QlYRXyllTDK1TFY4S6VQVPTIVd8VBYQKolBF9655CxXW1Q5GPiA4hMPoKBqFsm6jegRVXLoMyr3I1wgxYO5K14a6irAd-8k6WSpcibAxn2tkcHY66F_E13fnl_2j6zhPpBGxzAEg5Ypz6pSWLvOZYglPOO8WOVU68ZQbYSARqfOgM659wXMlskJ4qcUa2ZnZjpr6fQzY2mHAHMrSVVCP0aZUpioxVHXk7ozMmxqxgcKOmjB0zcQyaqfF2a44-11cx27NXcfZEPwv-dNUB2zPATe9u2hclQf842R3UZJOQw9m3EcoYfJ_or05efyJjmeKgC18_iq6X1ilhZb26fbcDl7Ork5uH57tsfgCMkeS0w</recordid><startdate>201111</startdate><enddate>201111</enddate><creator>Altman, Robert D.</creator><creator>Lang, Anthony E.</creator><creator>Postuma, Ronald B.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201111</creationdate><title>Caffeine in Parkinson's disease: A pilot open-label, dose-escalation study</title><author>Altman, Robert D. ; Lang, Anthony E. ; Postuma, Ronald B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4583-5ceee926220a675abdb6142422ceec0674d02838e439ade7b27df2c63bf3d573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>caffeine</topic><topic>Caffeine - administration & dosage</topic><topic>Caffeine - adverse effects</topic><topic>clinical trials</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>Dose-Response Relationship, Drug</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>neuroprotection</topic><topic>Parkinson Disease - drug therapy</topic><topic>Parkinson Disease - physiopathology</topic><topic>Parkinson's disease</topic><topic>Pilot Projects</topic><topic>Psychiatric Status Rating Scales</topic><topic>Severity of Illness Index</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Altman, Robert D.</creatorcontrib><creatorcontrib>Lang, Anthony E.</creatorcontrib><creatorcontrib>Postuma, Ronald B.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Movement disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Altman, Robert D.</au><au>Lang, Anthony E.</au><au>Postuma, Ronald B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Caffeine in Parkinson's disease: A pilot open-label, dose-escalation study</atitle><jtitle>Movement disorders</jtitle><addtitle>Mov. Disord</addtitle><date>2011-11</date><risdate>2011</risdate><volume>26</volume><issue>13</issue><spage>2427</spage><epage>2431</epage><pages>2427-2431</pages><issn>0885-3185</issn><eissn>1531-8257</eissn><abstract>Introduction:
Epidemiologic studies consistently find an inverse association between caffeine use and PD. Numerous explanations exist, but are difficult to evaluate as caffeine's symptomatic effect and tolerability in PD are unknown.
Patients and Methods:
We designed an open‐label, 6‐week dose‐escalation study of caffeine to establish dose tolerability and evaluate potential motor/nonmotor benefits. Caffeine was started at 200 mg daily and was increased to a maximum of 1,000 mg.
Results:
Of 25 subjects, 20 tolerated 200 mg, 17 tolerated 400 mg, 7 tolerated 800 mg, and 3 tolerated 1,000 mg. The most common adverse events were gastrointestinal discomfort, anxiety, and worsening/emerging tremor. At 400 mg daily, we found potential improvements in motor manifestations and somnolence (UPDRS III: −4.5 ± 4.6, P = 0.003; Epworth: −2.0 ± 3.0, P = 0.015).
Conclusion:
Maximum dose tolerability for caffeine in PD appears to be 100 to 200 mg BID. We found pilot preliminary evidence that caffeine may improve some motor and nonmotor aspects of PD, which must be confirmed in longer term, placebo‐controlled, clinical trials. © 2011 Movement Disorder Society</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>21953603</pmid><doi>10.1002/mds.23873</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences caffeine Caffeine - administration & dosage Caffeine - adverse effects clinical trials Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Dose-Response Relationship, Drug Humans Medical sciences Middle Aged Neurology neuroprotection Parkinson Disease - drug therapy Parkinson Disease - physiopathology Parkinson's disease Pilot Projects Psychiatric Status Rating Scales Severity of Illness Index Treatment Outcome |
| title | Caffeine in Parkinson's disease: A pilot open-label, dose-escalation study |
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