Caffeine in Parkinson's disease: A pilot open-label, dose-escalation study§

Authors


  • Funding agencies: This study was supported by grants from the Canadian Institutes of Health Research (to R.B.P. and A.E.L.) by the Fonds de la recherche en santé du Québec (to R.B.P.), and by the Webster Foundation (to R.B.P.).

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • §

    Full financial disclosures and author roles may be found in the online version of this article.

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

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