Caffeine might help to improve movement for people with Parkinson's disease, a small new study suggests. But, despite caffeine's reputation as a stimulant, the study did not show a clear reduction in daytime sleepiness. The study included 61 people with Parkinson's disease. Before the study, all of them consumed less than 200 milligrams of caffeine daily. That's equal to about 2 cups of coffee. People were randomly divided into 2 groups. One group took pills containing caffeine twice a day -- after they got up and at lunchtime. The pills contained 100 milligrams of caffeine each – similar to a cup of coffee. The other group received look-alike placebo pills that contained no caffeine. After 3 weeks, the dose was doubled, to 200 milligrams twice a day. Tests showed greater speed of movement and less stiffness in those who received the real caffeine pills. There also appeared to be an improvement in daytime sleepiness for those taking caffeine. But the difference between the groups was so small it could have been caused by chance. The journal Neurology published the study. HealthDay News wrote about it August 1.

By Robert H. Shmerling, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

Have you heard about the health benefits of coffee?

In recent years, studies have compared rates of disease between coffee drinkers and non-drinkers. Coffee drinkers were found to have lower rates of newly diagnosed:

• Cancer of various types (including liver, prostate and rectal cancer)
• Cirrhosis
• Type 2 diabetes
• Gout
• Memory loss (among older women)
• Parkinson's disease

If drinking coffee is linked with a lower rate of Parkinson's disease, could caffeine reduce symptoms in people who already have the disease? That's just what a new study has found.

The study included 61 people with Parkinson's disease. They were randomly assigned to treatment with a placebo or caffeine. The amounts of caffeine were equal to about 2 to 4 cups of coffee per day.

Those taking caffeine reported modest improvement in stiffness and speed of movement. Slow movement and stiffness are typical symptoms of Parkinson's disease.

Caffeine treatment did not affect involuntary movements (called tremor) -- also typical of Parkinson's disease. That's fortunate since some people feel "shaky" after drinking caffeine.

Other measures did not improve. These included alertness during the day, sleep quality and quality of life.

It's too soon to say if caffeine may become a treatment for Parkinson's disease. The study was too small to prove anything. Also, it lasted only 6 weeks and the benefits were small.

Still, these findings could lead to important future research. And it is reassuring for those who have Parkinson's disease that drinking coffee probably is not making things worse. It may even be helping.

What Changes Can I Make Now?

If you have Parkinson's disease, talk to your doctor about your treatment options. They include:

• No treatment, especially if symptoms are minor
• Medicines –These include levodopa (Larodopa, Dopar), bromocriptine (Parlodel), pramipexole (Mirapex) and ropinirole (Requip). A new option is rotigotine (Neupro), a patch just approved this year. These treatments are worth considering if symptoms interfere with your daily activities, work or caring for yourself.
• Physical activity -- Increasing your ease of movement and improving strength and balance may reduce the risk of falls and improve overall function. Working with a physical therapist may be helpful.
• Depression treatment -- Many people with Parkinson's disease also have depression. Counseling, medicines or other efforts to counter depression (including exercise) can make a big difference.
• Brain stimulation -- Recent studies suggest that electrical stimulation of the brain may provide major benefits. Stimulation occurs through wires implanted by surgery. This is usually reserved for people with more severe disease.

Keep in mind that not all of caffeine's effects on the body are helpful. Caffeine can cause heartburn and sleep problems. It makes some people feel "wired." It's also a diuretic --that is, it increases urination. At least one study has suggested a link between drinking coffee and heart attack.

What Can I Expect Looking to the Future?

The finding that caffeine may reduce symptoms of Parkinson's disease is intriguing. If other research confirms it, you can expect to hear much more.

Likely topics for further research include how much caffeine intake is best, why it works and whether there is a critical time during which it's most helpful. For example, is caffeine more protective right after you are diagnosed with Parkinson's disease? In the future, we may learn more about how caffeine and coffee help people with Parkinson's disease (and other conditions). That could lead to effective new treatments.

Few doctors currently recommend drinking coffee for its health benefits. But, if the current trends continue, maybe they will.