scholarly journals Method of Addition of Bromocriptine to the Drug Regime of Patients with Advanced Parkinson’s Disease

1981 ◽  
Vol 8 (1) ◽  
pp. 31-34 ◽  
Author(s):  
J. David Grimes ◽  
Mohamed N. Hassan
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Adverse Effects ◽  
Gradual Increase ◽  
Advanced Parkinson’S Disease ◽  
Number Of Patients ◽  
Concomitant Reduction

SUMMARYUsing a method of a gradual increase of bromocriptine with a concomitant reduction of Sinemet® (levodopa 250 mg + carhidopa 25 mg), 19 patients with advanced Parkinson’s disease have been treated for periods of up to 22 months and 16 of them have shown improvements of varying degrees. Eighteen patients were able to tolerate bromocriptine addition, with early transient adverse effects occurring in seven cases. In contrast to several previously reported studies, it was found necessary to withdraw bromocriptine in only one case.With the drugs currently available, bromocriptine has a role in the management of patients with advanced Parkinson’s disease. The method described here may allow a greater number of patients to be given a trial with this drug.

scholarly journals Use of clozapine in Brazilian patients with Parkinson's disease

2008 ◽  
Vol 66 (3b) ◽  
pp. 611-614 ◽  
Author(s):  
Laura Gomide ◽  
Arthur Kummer ◽  
Francisco Cardoso ◽  
Antonio Lucio Teixeira
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Adverse Effects ◽  
Chart Review ◽  
Maximum Dose ◽  
Retrospective Chart Review ◽  
Advanced Parkinson’S Disease ◽  
Brazilian Sample ◽  
Average Maximum ◽  
Psychiatric Complications

Clozapine has been used as an attempt to manage levodopa complications in advanced Parkinson's disease (PD). To investigate the use of clozapine in this context in a Brazilian sample, a retrospective chart review was carried out at the Movement Disorders Clinic from the Federal University of Minas Gerais. This study enrolled 43 PD patients who used or were in use of clozapine. Patients had a mean age of 64 years and a mean UPDRS score of 55. Clozapine was indicated for dyskinesias in 17 patients, for psychosis in 15 and for both reasons in 11. The average maximum dose was 70 mg/day. Twenty six patients used it for a mean of 3.5 years. Twenty nine presented an improvement of their condition, 9 remained clinically stable. Twenty subjects interrupted the use of clozapine, being 9 due to adverse effects. Clozapine may play a role in the management of motor and psychiatric complications in PD, but it is associated with low tolerability.

scholarly journals Bromocriptine in the Management of End of Dose Deterioration in Parkinson’s Disease

1984 ◽  
Vol 11 (4) ◽  
pp. 452-456 ◽  
Author(s):  
J.D. Grimes ◽  
D.B. King ◽  
O.S. Kofman ◽  
P. Molina-Negro ◽  
A.F. Wilson ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Adverse Effects ◽  
Early Treatment ◽  
Disability Score ◽  
Advanced Parkinson’S Disease ◽  
Daily Dose ◽  
Small Doses ◽  
The Mean

ABSTRACTThirty-three patients with advanced Parkinson’s disease complicated by end of dose deterioration were treated with bromocriptine. The drug was slowly increased so that by treatment week 24 the mean daily dose of bromocriptine was 22mg and levodopa had been decreased by an average of 15 percent. The majority of improvement in daily fluctuations and Parkinsonian disability score was documented by 8 weeks, at which time the mean daily bromocriptine dose was only 12mg.End of dose deterioration was reduced in 78 percent of the patients (mean 43% improvement). Total Parkinsonian disability score was decreased by 33 percent. Adverse effects were minimal; the most common was mild transient early treatment nausea which occurred in 15 percent of the patients.The slow introduction of small doses of bromocriptine, combined with minimal levodopa reduction, can give Parkinsonian patients significant improvement in end of dose deterioration.

scholarly journals Deprenyl in Parkinson’s Disease: Mechanisms, Neuroprotective Effect, Indications and Adverse Effects

1992 ◽  
Vol 19 (S1) ◽  
pp. 142-146 ◽  
Author(s):  
Paul Vezina ◽  
Erich Mohr ◽  
David Grimes
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Adverse Effects ◽  
Neuroprotective Effect ◽  
Dopamine Neurons ◽  
Advanced Parkinson’S Disease ◽  
Ulcer Disease ◽  
Daily Dose ◽  
Higher Doses ◽  
Symptomatic Benefit

ABSTRACT:Deprenyl is a synthetic, selective inhibitor of the monoamine oxidase-B enzyme system. The mechanism of its beneficial effect in early and advanced Parkinson’s disease is not settled. Increased striatal dopamine accumulation, sensitization of surviving dopamine neurons with increased dopamine production and reduced nigro-striatal toxicity may all contribute. The standard daily dose of deprenyl is 10 mg. Selectivity may be lost at higher doses. Deprenyl is especially indicated in untreated patients, improving up to 50 percent of patients with mild motor fluctuations. Major symptomatic benefit also occurs in occasional levodopa treated patients. Adverse effects are common, however. Increase dyskinesias, confusion and hallucinations, nausea and postural hypotension may necessitate drug withdrawal or the use of low dose regimens. Caution should be exercised with older patients, those with ulcer disease, which may be worsened by deprenyl, and individuals with active ischemic heart disease where the safety of this drug is not yet clear.

scholarly journals Management Challenges of Severe, Complex Dyskinesia. Data from a Large Cohort of Patients Treated with Levodopa-Carbidopa Intestinal Gel for Advanced Parkinson’s Disease

2021 ◽  
Vol 11 (7) ◽  
pp. 826
Author(s):  
József Attila Szász ◽  
Viorelia Adelina Constantin ◽  
Károly Orbán-Kis ◽  
Ligia Ariana Bancu ◽  
Marius Ciorba ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Fluctuations ◽  
Advanced Parkinson’S Disease ◽  
Number Of Patients ◽  
Before And After ◽  
Advanced Stages ◽  
Complex Forms ◽  
Time Of Administration

Background: In the advanced stages of Parkinson’s disease (APD), complex forms of dyskinesia may severely impair the patient’s quality of life. Objective: In the present study, we aimed to analyze the evolution under LCIG therapy of the most important motor fluctuations and complex disabling dyskinesias, including diphasic dyskinesia. Methods: In this retrospective study, we analyzed the characteristics of patients with APD who had at least 30 min of diphasic dyskinesia (DID) in 3 consecutive days, were considered responders and were treated with LCIG in our clinic. Patients were evaluated before and after PEG and at 6, 12 and 18 months, when the changes in the therapy were recorded, and they completed a 7-point Global Patient Impression of Improvement (PGI-I) scale. Results: Forty patients fulfilled the inclusion criteria—out of which, 34 performed all visits. There was a substantial difference between the calculated and real LCIG (1232 ± 337 mg vs. 1823 ± 728 mg). The motor fluctuations and most dyskinesias improved significantly after starting LCIG, but an increasing number of patients needed longer daily administrations of LCIG (24 instead of 16 h). Conclusions: Patients with APD with complex dyskinesias must be tested in dedicated hospitals, and they need a special therapeutic approach. The properly adapted LCIG treatment regarding the dose and time of administration completed with well-selected add-on medication should offer improvement for patients who want to or can only choose this DAT vs. others.

scholarly journals Translating Evidence to Advanced Parkinson's Disease Patients: A Systematic Review and Meta‐Analysis

2021 ◽  
Author(s):  
Frouke A.P. Nijhuis ◽  
Rianne Esselink ◽  
Rob M.A. Bie ◽  
Hans Groenewoud ◽  
Bastiaan R. Bloem ◽  
...  
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Meta Analysis ◽  
Advanced Parkinson’S Disease

scholarly journals Intrajejunal Infusion of Levodopa/Carbidopa for Advanced Parkinson's Disease: A Systematic Review

2021 ◽  
Author(s):  
Taiji Tsunemi ◽  
Genko Oyama ◽  
Shinji Saiki ◽  
Taku Hatano ◽  
Jiro Fukae ◽  
...  
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Advanced Parkinson’S Disease

scholarly journals Unexplained worsening of parkinsonian symptoms in a patient with advanced Parkinson’s disease as the sole initial presentation of COVID-19 infection: a case report

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Walaa A. Kamel ◽  
Ismail Ibrahim Ismail ◽  
Mohamed Ibrahim ◽  
Jasem Y. Al-Hashel
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Viral Infections ◽  
Neurological Complications ◽  
Initial Presentation ◽  
Nasopharyngeal Swab ◽  
Initial Manifestation ◽  
Advanced Parkinson’S Disease ◽  
Case Presentation ◽  
Dystonic Posturing

Abstract Background Parkinson’s disease (PD) is a neurodegenerative condition that has been reported following viral infections in rare occasions. Several neurological complications have emerged in association with coronavirus disease 2019 (COVID-19), since its declaration as a pandemic. Herein, we present a novel case of unexplained worsening of PD as the sole initial presentation of COVID-19, in the absence of fever or respiratory symptoms. Case presentation A 56-year-old male with advanced PD presented with severe rigidity, dystonic posturing of both feet, and confusion of 4 days duration. His condition progressed to an akinetic-rigid state and confusion during the following week, and a routine nasopharyngeal swab tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the 9th day of onset. He developed fever and dyspnea later and was intubated on the 10th day. Conclusion To our knowledge, worsening of PD symptoms as the sole initial manifestation of SARS-CoV-2 infection, in the absence of other cardinal features of COVID-19, has not been reported in the literature. We suggest testing for COVID-19 infection in patients with PD, especially advanced cases, who present with unexplained worsening of symptoms, even in the absence of COVID-19 cardinal features.

Long term follow-up in advanced Parkinson’s disease treated with DBS of the subthalamic nucleus

2021 ◽  
Author(s):  
Maria Antonietta Volonté ◽  
Giacomo Clarizio ◽  
Sebastiano Galantucci ◽  
Pietro Giuseppe Scamarcia ◽  
Rosalinda Cardamone ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Subthalamic Nucleus ◽  
Advanced Parkinson’S Disease ◽  
Long Term Follow Up
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