Cantello 1986.

Methods	Randomised, double‐blind cross‐over study of bornaprine vs placebo. Randomisation method not stated. Setting: 1 site (Italy). Duration: 2 months, each period: 30 days.
Participants	30 patients: 17 female, 13 male. Age: 50‐70 (mean: 65) years. Disease duration: not stated. Disease severity: 14 patients H&Y II, 13: III, 2: IV, 1: V. Inclusion criteria: IPD with tremor; age 35‐70; stable dose of L‐dopa or bromocriptine "without adequate control of symptoms". Exclusion criteria: Glaucoma, gastrointestinal stenosis, myocardial infarction in previous year, hyperkinetic cardiac arrhythmias, mental deterioration.
Interventions	Cross‐over design: 30 days drug / placebo ‐ 30 days placebo / drug. No wash‐out period. Drug titrated to maximum of 12 mg/day if tolerated. Length of titration period not stated. Mean dose: 8.25 mg/day (SD 2.8). L‐dopa and /or bromocriptine kept stable, doses not stated. Other antiparkinsonian drugs allowed, not specified.
Outcomes	Webster scale: ‐ Tremor: most marked improvement: from 2.48 baseline to 1.18 on drug and 2.00 on placebo; both: p<0.01. ‐Bradykinesia, rigidity, posture, facial expression, seborrhea, coping ability: all significantly (p<0.05) improved on drug; on placebo: less marked, but significant. Subjective assessment by patients and investigators: ‐Efficacy: significant (p<0.01) difference in favour of bornaprine. ‐Tolerability: no significant difference. Neuropsychiatric AE: ‐Drug: "psychic disturbance" in 1 patient, insomnia in 2. Placebo: none. Drop‐outs: 3, failure to attend; allocation not stated.
Notes	Not intention‐to‐treat. No wash‐out period.
Risk of bias
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	B ‐ Unclear