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Caffeine consumption and risk of dyskinesia in CALM-PD


  • Funding agencies: The study was supported by the Michael J. Fox Foundation for Parkinson's Research Fast Track 2001 Program, the Parkinson's Disease Foundation, and NIH grants R01NS054978 and K24NS60991.

  • Relevant conflicts of interest/financial disclosures: The present study is a secondary analysis of the database of a clinical trial, CALM-PD, and its extension study, CALM Cohort, which were sponsored by Pharmacia Corporation (Peapack, NJ) and Boehringer Ingelheim (Ingelheim, Germany). In January 2001 Pharmacia approved an investigator (Michael A. Schwarzschild)–initiated proposal to introduce an add-on caffeine questionnaire to CALM-PD subjects to test our prespecified hypotheses that higher caffeine consumption is associated with lower rates of dyskinesia development and/or disease progression. Neither Pharmacia nor Boehringer Ingelheim provided funding for or otherwise supported or participated in the present study. Anne-Marie A. Wills participates in the Schering-Plough-sponsored clinical trials of Preladenant and has served as a consultant for Accordant (a CVS/Caremark disease management company), for Asubio Pharmaceuticals, and for NanoDerma Ltd. Shirley Eberly has received research support from the NIH, DOD, Michael J Fox Foundation, Parkinson's Disease Foundation, Cephalon, and Lundbeck. Anthony E. Lang has served as an adviser for Abbott, Allon Therapeutics, Astra Zenica, Avanir Pharmaceuticals, Biovail, Boerhinger-Ingelheim, Cephalon, Ceregene, Eisai, GSK, Lundbeck A/S, Medtronic, Merck Serono, Novartis, Santhera, Solvay, and Teva; has received honoraria from Teva; has received grants from the Canadian Institutes of Health Research, Dystonia Medical Research Foundation, Michael J. Fox Foundation, National Parkinson Foundation, and Ontario Problem Gambling Research Centre; received publishing royalties from Saunders, Wiley-Blackwell, Johns Hopkins Press, and Cambridge University Press; and has served as an expert witness in cases related to the welding industry. Daniel M. Togasaki participated in the Schering-Plough-sponsored open-label extension study of Preladenant. Caroline M. Tanner is an employee of the Parkinson's Institute; serves on the Scientific Advisory Boards of the Michael J. Fox Foundation and the National Spasmodic Dystonia Association; has provided consulting services to Impax Pharmaceuticals and Adamas Pharmaceuticals; has received grant support from the Michael J. Fox Foundation, the Brin Foundation, James and Sharron Clark, the Parkinson's Institute and Clinical Center, the Parkinson's Disease Foundation, USAMRAA (TATRC managed NETRP Program), National Institute of Neurological Disorders and Stroke (NINDS), and the Agency for Healthcare and Research Quality (AHRQ). Cornelia Kamp is supported by research grants from NINDS, the Michael J. Fox Foundation, and the Friedreich's Ataxia Research Alliance. Jiang-Fan Chen has served as a consultant for Kyowa Pharmaceutical, Inc., and Adenosine Therapeutics. David Oakes has received support from the NIH, the Department of Defense, and the Michael J. Fox Foundation for his research into Parkinson's disease and has received an honorarium from Novo Nordisk Inc. for consulting about an unrelated topic. Michael P. McDermott received research grants from the NIH, FDA, CDC, Muscular Dystrophy Association, SMA Foundation, Michael J. Fox Foundation, Boehringer-Ingelheim Pharmaceuticals, Inc., NeuroSearch Sweden AB, and Medivation, Inc., and served as a consultant for the NY State Department of Health, Pfizer, Inc., Smith and Nephew, Inc., Synosia, Inc., Teva Pharmaceutical Industries, Ltd., Impax Pharmaceuticals, and Bioness, Inc.

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

Correspondence to: Dr. Michael Schwarzschild, MassGeneral Institute for Neurodegenerative Disease, 114 16th Street, Boston, MA 02129, USA;



Adenosine A2A receptor antagonists reduce or prevent the development of dyskinesia in animal models of levodopa-induced dyskinesia.


We examined the association between self-reported intake of the A2A receptor antagonist caffeine and time to dyskinesia in the Comparison of the Agonist Pramipexole with Levodopa on Motor Complications of Parkinson's Disease (CALM-PD) and CALM Cohort extension studies, using a Cox proportional hazards model adjusting for age, baseline Parkinson's severity, site, and initial treatment with pramipexole or levodopa.


For subjects who consumed >12 ounces of coffee/day, the adjusted hazard ratio for the development of dyskinesia was 0.61 (95% CI, 0.37–1.01) compared with subjects who consumed <4 ounces/day. For subjects who consumed between 4 and 12 ounces/day, the adjusted hazard ratio was 0.73 (95% CI, 0.46–1.15; test for trend, P = .05).


These results support the possibility that caffeine may reduce the likelihood of developing dyskinesia. © 2013 Movement Disorder Society