Lisuride versus bromocriptine treatment in Parkinson disease

LeWitt, P.; Gopinathan, Govindan; Ward, C D; Sanes, Jerome N.; Dambrosia, James M.; Durso, Raymon; Calne, D. B.

doi:10.1212/wnl.32.1.69

Cited by 58 publications

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“…Likewise, the moderate and unchanged level of the lisuride dosage (average 1 mg/day) shows that, by tapering in by 0.1 mg graduations per week and with a good understanding of the expected undesirable effects, the investigators rapidly found what appeared to them as the optimal dosage. The observed undesirable effects (psychiatric effects including sleep disorders, digestive disorders such as nausea and vomiting at treatment onset) were in agreement with published data concerning dopaminergic agonists [22, 23, 24, 25, 26, 27, 28]. …”

Section: Discussionsupporting

confidence: 90%

Five-Year Follow-Up of Early Lisuride and Levodopa Combination Therapy versus Levodopa Monotherapy in de novo Parkinson’s Disease

et al. 2000

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The value of an early initial coadministration of levodopa (L-dopa) and lisuride in Parkinson’s disease was the main goal of the present study. Eighty-two patients with recently diagnosed idiopathic Parkinson’s disease were randomized into two groups for treatment with L-dopa alone or L-dopa + lisuride. The trial was double-blinded for the first year and open for the following 4 years. Selegiline (10 mg/day b.i.d.) was added in both groups at the end of the first year. Outcome measures were evolution of L-dopa dosage and Unified Parkinson’s Disease Rating Scale scores and subscores, and incidence of motor complications. The dropout rate was higher in the L-dopa group (63.4%) than in the combination group. Motor improvement was better (p < 0.01) in the L-dopa + lisuride group. Expected motor complications were rare, moderate and equivalent in the two groups despite a difference in L-dopa dosage (446.7 vs. 387.5 mg/day). Long-term follow-up demonstrated the L-dopa-sparing effect of lisuride (average 1 mg/day), the beneficial effect of early combination therapy on motor status and the paucity of motor complications in both groups.

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Section: Discussionsupporting

confidence: 90%

Five-Year Follow-Up of Early Lisuride and Levodopa Combination Therapy versus Levodopa Monotherapy in de novo Parkinson’s Disease

et al. 2000

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“…Adverse reactions included psychiatric reactions (n = 6), drowsiness (n = 9), gastrointestinal symptoms (n = 8), and light-headedness (n = 11). LeWitt et al (1982) 5 : As this study is previously reviewed in the Bromocriptine section, only a brief review is included here. The study was a double-blind, randomized, cross-over (7-10 weeks per period of treatment) trial conducted in 28 patients with PD.…”

Section: Level-ii Studies (Placebo Controlled Studies)mentioning

confidence: 99%

“…In two studies, psychiatric adverse reactions were reported more frequently in the lisuride treatment-group than in patients receiving bromocriptine 5 or DHEC. 7 However, these short-term studies are limited and do not permit conclusions on the safety of long-term use of lisuride.…”

Section: Review Of Safetymentioning

confidence: 99%

DA agonists - Ergot derivaties: Lisuride

2002

Mov Disord.

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Lisuride is an alpha-amino-ergoline with D2 receptor agonist properties and has no apparent D1 receptor effects. Similar to most ergotamine derivatives, lisuride also has 5-HT2 activity. In animal models of Parkinson's disease (PD), lisuride antagonizes reserpine-induced akinesia and induces rotation in the unilaterally 6-OHDA-lesioned rat. Lisuride lowers serum prolactin levels, induces nausea, and lowers blood pressure in healthy volunteers. 1 PHARMACOKINETICSAfter oral administration, lisuride is absorbed completely from the gastrointestinal tract. Peak plasma levels are obtained between 60 to 80 minutes, with high individual variation. Terminal half-life for elimination of lisuride from the plasma is around 2 hours, which is shorter than most other dopamine agonists. Similar to other ergotamine derivatives, absolute oral bioavailability of lisuride is low due to first pass metabolism ranging between 10 to 20%. 60 to 70% of lisuride is bound to human plasma proteins. Lisuride is extensively metabolised with more than 15 metabolites identified.Lisuride has solubility properties similar to apomorphine and therefore can be given subcutaneously and intravenously. REVIEW OF CLINICAL STUDIES PREVENTION OF DISEASE PROGRESSIONNo qualified studies were identified. SYMPTOMATIC CONTROL OF PARKINSONISM MONOTHERAPYOnly one randomized (Level-I) study assessing the effect of lisuride in L-dopa-naïve de novo PD patients was identified, according to the inclusion criteria.Rinne (1989) 2 :This was an open-label, parallel-group, L-dopacontrolled study including 90 patients (mean age 62 years) randomized into 3 different arms: lisuride alone, L-dopa alone, and lisuride plus L-dopa as early combination. If the therapeutic response in the lisuride arm was insufficient after 3 months of treatment, L-dopa could be added to form a second early combination group. Efficacy was assessed using the CURS (Columbia University Rating Scale). Patients recorded, in a daily diary, the occurrence and severity of fluctuations in disability, and were followed for 4 years. After 3 months of follow-up, lisuride monotherapy was less effective than L-dopa (daily doses not given) (CURS percent improvement: L-dopa 56% vs. lisuride 32%, p<0.01). After 4 years of treatment, only 17% of the patients were maintained on lisuride monotherapy. In the other patients L-dopa supplementation was required. After 4 years of follow-up, early combination of lisuride (1.1 mg/d) and low-dose of L-dopa (484 mg/d) resulted in an antiparkinsonian response equal to that achieved with higher doses of L-dopa monotherapy (668 mg/d) (% improvement CURS: combination regimen 28% vs. L-dopa 25%). A similar improvement was reported in the group of lisuride-treated patients who received early L-dopa supplementation after 3 months of treatment (lisuride daily dose = 0.8 combined with 630 mg/d of Ldopa, % improvement CURS: 29%). For both groups that received combination therapy, there were significantly fewer end-of-dose failures and dyskinesias (see "Prevention of Motor Complications"...

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“…We have studied the effect of both drugs on IOP and pupil diameter, using bromocriptine as a positive control and for purposes of comparison of efficacy. The doses of the two drugs chosen are those of an approximate efficacy to that of 1.25 mg bromocriptine in treatment of Parkinson's disease and serum prolactin level reduction (LeWitt et al, 1982;Ciccarelli et al, 1988). No serious side effects were found with these doses in a pilot study in mobile normal volunteers.…”

Section: Introductionmentioning

confidence: 99%

The effects of lisuride, terguride and bromocriptine on intraocular pressure (IOP).

Al-Sereiti

Turner

1989

Brit J Clinical Pharma

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1 The effects of a single oral dose of the dopaminergic agonists lisuride (0.1 mg), terguride (0.25 mg) and bromocriptine (1.25 mg) on IOP were studied in eight normal volunteers using the non-contact tonometer. 2 Considering all post-dose measurements, compared with placebo, bromocriptine and lisuride but not terguride reduced IOP significantly in both eyes. 3 There was no significant difference between the ocular hypotensive effect of bromocriptine and lisuride. 4 Terguride reduced IOP significantly in the left eye at the 3 h time point after drug administration. 5 The result of this study confirms the reported ocular hypotensive effect of bromocriptine and showed that lisuride is as effective as bromocriptine in reducing IOP. 6 To evaluate the clinical importance of these drugs as ocular hypotensive agents other studies are needed using eye drops.

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Lisuride versus bromocriptine treatment in Parkinson disease

Cited by 58 publications

References 0 publications

Five-Year Follow-Up of Early Lisuride and Levodopa Combination Therapy versus Levodopa Monotherapy in de novo Parkinson’s Disease

Five-Year Follow-Up of Early Lisuride and Levodopa Combination Therapy versus Levodopa Monotherapy in de novo Parkinson’s Disease

DA agonists - Ergot derivaties: Lisuride

The effects of lisuride, terguride and bromocriptine on intraocular pressure (IOP).

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