Dopamine agonists for parkinson’s disease

1991 ◽  
Vol 29 (2) ◽  
pp. 7-8
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Side Effects ◽  
Therapeutic Efficacy ◽  
Dopamine Agonists ◽  
Dopa Decarboxylase ◽  
Decarboxylase Inhibitor ◽  
Duration Of Action ◽  
Motor Disability ◽  
The Uk

Bromocriptine, lysuride (formerly lisuride, Revanil – Roche) and pergolide (not yet marketed in the UK) are dopamine agonists developed for use in the treatment of patients with Parkinson’s disease. Combination of a dopamine agonist with levodopa plus a dopa-decarboxylase inhibitor (‘co-dieldopa’)* may have advantages at all stages of the disease. The aim of combined co-dieldopa + agonist treatment is to limit some of the problems with prolonged co-dieldopa use alone; especially fluctuations in motor disability.1 It is still not clear how the three agonists compare with each other for therapeutic efficacy, duration of action, and side effects, nor how they are best combined with co-dieldopa.

Small doses of levodopa for parkinson’s disease

1990 ◽  
Vol 28 (14) ◽  
pp. 55-56
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Effective Dose ◽  
Low Dose ◽  
Dopa Decarboxylase ◽  
Decarboxylase Inhibitor ◽  
Minimum Effective Dose ◽  
Small Doses ◽  
Full Discussion ◽  
Low Strength

Our last full discussion of Parkinson’s disease recommended using the minimum effective dose of levodopa in combination with a peripheral dopa decarboxylase inhibitor1 - carbidopa in Sinemet (co-careldopa) and benserazide in Madopar (co-beneldopa). Combined formulations offer levodopa in various doses together with an inhibitor: Madopar 62.5 contains levodopa 50mg + benserazide 12.5mg base; low strength Sinemet, Sinemet-LS, contains levodopa 50mg + carbidopa 12.5mg. Both these preparations offer a relatively low dose but the Sinemet-LS tablet is scored and the 62.5mg tablet of Madopar Dispersible can be broken so that even lower doses can be used. This article examines when these small doses are useful.

scholarly journals Neuropsychiatric and metabolic aspects of dopaminergic therapy: perspectives from an endocrinologist and a psychiatrist

2018 ◽  
Vol 7 (2) ◽  
pp. R88-R94 ◽  
Author(s):  
Anastasia P Athanasoulia-Kaspar ◽  
Kathrin H Popp ◽  
Gunter Karl Stalla
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Side Effects ◽  
Pituitary Adenomas ◽  
Dopamine Agonists ◽  
De Novo ◽  
Gastrointestinal Symptoms ◽  
Primary Treatment ◽  
Metabolic System ◽  
Prolactin Synthesis

The dopaminergic treatment represents the primary treatment in prolactinomas, which are the most common pituitary adenomas and account for about 40% of all pituitary tumours with an annual incidence of six to ten cases per million population. The dopaminergic treatment includes ergot and non-ergot derivatives with high affinity for the dopamine receptors D1 or/and D2. Through the activation of the dopaminergic pathway on pituitary lactotrophs, the dopamine agonists inhibit the prolactin synthesis and secretion, therefore normalizing the prolactin levels and restoring eugonadism, but they also lead to tumour shrinkage. Treatment with dopamine agonists has been associated – apart from the common side effects such as gastrointestinal symptoms, dizziness and hypotension – with neuropsychiatric side effects such as impulse control disorders (e.g. pathological gambling, compulsive shopping, hypersexuality and binge eating) and also with behavioral changes from low mood, irritability and verbal aggressiveness up to psychotic and manic symptoms and paranoid delusions not only in patients with prolactinomas but also in patients with Parkinson’s disease and restless leg syndrome. They usually have de novo onset after initiation of the dopaminergic treatment and have been mainly reported in patients with Parkinson’s disease, who are being treated with higher doses of dopamine agonists. Moreover, dopamine and prolactin seem to play an essential role in the metabolic pathway. Patients with hyperprolactinemia tend to have increased body weight and an altered metabolic profile with hyperinsulinemia and increased prevalence of diabetes mellitus in comparison to healthy individuals and patients with non-functioning pituitary adenomas. Treatment with dopamine agonists in these patients in short-term studies seems to lead to weight loss and amelioration of the metabolic changes. Together these observations provide evidence that dopamine and prolactin have a crucial role both in the regard and metabolic system, findings that merit further investigation in long-term studies.

Parkinson’s disease

2001 ◽  
Vol 11 (1) ◽  
pp. 33-49 ◽  
Author(s):  
Graeme JA Macphee ◽  
David A Stewart
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Health Planning ◽  
New Paradigm ◽  
Motor Disability ◽  
Holistic Management ◽  
Stable Maintenance ◽  
The Uk

Parkinson’s disease (PD) is a progressive neurological disorder affecting at least 120 000 persons in the UK today. Age is the most potent risk factor. With the rising numbers of elderly, PD will become an increasingly important cause of disability and mortality. This has significant implications for health planning.In recent years, there has been growing emphasis on the key role of the specialist clinic, interdisciplinary team and the PD specialist nurse in the management of the condition, as well as recognition that quality of life for people with PD and their carers relates to more than motor disability and disease severity. Appropriate care planning requires skilled assessment, and a new paradigm, incorporating four progressive clinical management stages (diagnosis, stable maintenance stage, complex stage and palliative stage) may be useful. The importance of all these aspects to successful holistic management of PD should be emphasized but is beyond the scope of this review, as is diagnosis, which is the subject of a separate contribution.

Treatment of Parkinson's disease with l-DOPA and an association l-DOPA plus a DOPA decarboxylase inhibitor

1972 ◽  
Vol 202 (4) ◽  
pp. 347-355 ◽  
Author(s):  
C. Fazio ◽  
A. Agnoli ◽  
M. Casacchia ◽  
M. Reitano ◽  
S. Ruggieri ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dopa Decarboxylase ◽  
Decarboxylase Inhibitor

scholarly journals Review of medicine utilization for Parkinson’s disease management: the Bulgarian perspective

2021 ◽  
Author(s):  
Zornitsa Mitkova ◽  
Maria Kamusheva ◽  
Dobrinka Kalpachka ◽  
Desislava Ignatova ◽  
Konstantin Tachkov ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dopamine Agonists ◽  
Neurodegenerative Disorder ◽  
Disease Prevalence ◽  
Published Data ◽  
Decarboxylase Inhibitor ◽  
Inclusion Criteria ◽  
Treatment Approaches ◽  
Common Neurodegenerative Disorder

Background: Parkinson’s disease (PD), which occurs in 1% of the population, is the second most common neurodegenerative disorder. Despite the broad spectrum of PD manifestations and high disease prevalence, there are insufficient data on medicine utilization and prescription strategies. The purpose of the current study was to analyze published data concerning treatment approaches and to compare them with Bulgarian therapeutic practice.Design and methods: We conducted a systematic review of the PubMed and Google Scholar databases, and we calculated medicine utilization in Bulgaria during 2018 and 2019 using the WHO methodology.Results: The literature search identified a total of 311 publications, but only 12 met the inclusion criteria. Eleven studies pointed out that levodopa-containing medicine are the most frequently used, followed by dopamine agonists. The highest rate was found for levodopa-containing products and decarboxylase inhibitor (1.06 and 1.33 DDD/1000 inh/day), followed by anticholinergic Biperiden (0.494 and 0.455 DDD/1000 inh/day) during 2018 and 2019 in Bulgaria.Conclusion: Overall, the treatment approaches used in the last decade comply with guideline recommendations, despite variations in levodopa and dopamine agonist utilization. Even though new medicines have been approved for PD management, levodopa-containing products are still most often prescribed and used worldwide.

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