Bromocryptine in Levodopa Response-Losing Parkinsonism

Abstract

23 patients with advanced Parkinson’s disease were allocated in a double-blind study of bromocryptine. These patients had an insufficient or deteriorating response to levodopa treatment. The dosages of levodopa were optimal and stabilized 3 months prior to and during this 5-month study. The addition of bromocryptine in high doses (average daily dose 71 mg) induced a significant improvement in the total score of the Webster and the NUDS scales. The global assessment, both by the investigator and by the patients, also showed significant improvement. The efficacy of bromocryptine in these type of parkinsonian patients in a double-blind trial has not yet been established. The conclusion of this trial is that bromocryptine significantly increases the therapeutic effectiveness in these poorly levodopa responding parkinsonian patients.

The efficacy and safety of adjunct bromocriptine therapy for levodopa-induced motor complications: A systematic review

“…Six of eight coordinators responded. 13,14,16,17,19,20 One trialist was deceased and therefore the requested information could not be retrieved. 18…”

“…Only one trial reported age at onset. 13 The mean disease duration ranged from 8.5 18,19 to more than 13 years. 14 There were substantial differences between the studies with regard to the mean pretrial daily dosages of LD and the reported ratios of LD/decarboxylase inhibitor.…”

“…Maximum BR dosages at the end of the titration phase were reported by all trials and ranged from 20 14,15 to 100 mg per day. 19 Only four trials reported the diurnal distribution of the BR dosages at the end of the titration phase: three [16][17][18]20 or four times per day. 16,17 …”

“…Additionally obtained information showed that six trials 13,14,16,17,19,20 adequately randomized their patients by means of a computer randomization procedure or a randomization schedule. Hoehn apparently randomized 27 patients to the BR branch, whereas nine patients were allocated to the placebo group.…”

“…Additionally obtained information showed that this was adequately done by five trial coordinators. 13,14,16,19,20 …”