Objective:

To explore potential benefits and tolerability of extracts from Mucuna pruriens for dopaminergic treatment of Parkinson’s patients.

Background:

Capsules containing freeze-dried, aqueous extract from beans of Mucuna pruriens are commonly used by patients with Parkinson’s disease as a natural source of levodopa. Two studies have shown immediate effects of Mucuna extract on motor symptoms with some advantages over conventional levodopa preparations (e.g., Katzenschlager et al. 2004), and two open-label noninferiority studies (e.g., Cilia et al. 2018) suggest some efficacy and mixed tolerability over 3 or 4 months of treatment.

Method:

This presentation reports clinical experience from 5 patients (1 woman and 4 men, aged 60-81 years) in a neurology practice at a hospital using integrative medicine. The patients had signed a general consent form, and the local ethics committee deemed this study a case report series which requires no review. Medical records were screened for changes in UPDRS and medical treatment, including Mucuna pruriens capsules (470 mg extract with 15% levodopa) and other dopaminergic medication.

Results:

Three patients took Mucuna extract (4-6g/d) alone, without levodopa or dopa-decarboxylase inhibitor, and had a marked improvement of UPDRS, which was stable or even improved with stable dosage over 6-10 months. One patient added Mucuna extract (3.7g/d) to 300 mg/d of levodopa/benserazide while reducing ropinirole from 12 to 8 mg/d and had an improvement of total UPDRS from 41 to 25 over 15 months. One patient was able to reduce levodopa/carbidopa/entacapone from a levodopa effective dose 600 to 200 mg/d by adding 7.5g/d Mucuna with an improvement of total UPDRS from 43 to 24 over 10 months.

Most patients tolerated Mucuna well. One had temporary nausea and another had a temporary increase of dyskinesias, which could be corrected by further reduction of levodopa.

Conclusion:

Mucuna pruriens may have advantages as an additional option for dopaminergic treatment in some patients with Parkinson’s disease, and deserves further clinical studies to evaluate its safety and efficacy.

References: Cilia R et al. 2018: Daily intake of Mucuna pruriens in advanced Parkinson’s disease: A 16-week, noninferiority, randomized, crossover, pilot study. Parkinsonism and related disorders 49: 60-66.
Katzenschlager R et al. 2004: Mucuna pruriens in Parkinson’s disease: a double blind clinical and pharmacological study. J Neurol Neurosurg Psychiatry, 75: 1672–1677.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/observations-on-5-parkinsons-patients-taking-mucuna-pruriens-as-natural-source-of-levodopa/