Long‐term experience with pergolide therapy of advanced parkinsonism

Kurlan, Roger; Miller, Charlyne; Levy, Robert M.; Macik, Bernard; Hamill, Robert W.; Shoulson, Ira

doi:10.1212/wnl.35.5.738

Cited by 22 publications

(4 citation statements)

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“…Among conditions conducive to the emergence of denial symptoms, the patient's personality prior to the disease has been emphasised, 7 Accepted 2 November 1987 591 both hands. It was exacerbated by anxiety but not relieved by alcohol.…”

mentioning

confidence: 99%

Essential tremor cured by infarction adjacent to the thalamus.

Duncan¹,

Bone²,

Melville³

1988

Journal of Neurology, Neurosurgery & Psychiatry

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mentioning

confidence: 99%

Essential tremor cured by infarction adjacent to the thalamus.

Duncan¹,

Bone²,

Melville³

1988

Journal of Neurology, Neurosurgery & Psychiatry

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“…This objection of using low doses of levodopa can be fulfilled with either of the three combination strategies outlined above. Some researchers' [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]47 recommend the "early combination" strategy. However, if one wishes to delay the use of levodopa, then the only strategy left will be the one suggested by Rascol 36 and Olanow, 48 accepting the possibility of slightly lesser level of initial response by initiating treatment with bromocriptine, and adding L-DOPA/DI when required to control parkinsonian symptoms with a low incidence of side effects.…”

Section: Discussionmentioning

confidence: 99%

Optimum Symptomatic Control of Parkinson's Disease with Dopaminergic Therapy

Bouchard¹

1987

Can. J. Neurol. Sci.

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This paper presents a review of the literature on the therapeutic action and the side effects of the two main dopaminergic agents: L-DOPA/decarboxylase inhibitor (L-DOPA/DI) and bromocriptine (Parlodel ®) used either as monotherapy or in combination in patients with Parkinson's disease. The combination of L-DOPA/DI and bromocriptine gives the best therapeutic efficacy (49% improvement) in the total score (bradykinesia, rigidity and tremor). However, treatment by monotherapy or combination gives the same pattern of activity: greatest improvement in tremor, followed by rigidity and bradykinesia. Improvement observed in the short term is not sustained over longer periods of time for monotherapy with either drug. The short-term side effects are similar for each treatment, whereas long-term complications (dyskinesia, end-of-dose deterioration and on-off phenomenon) appear only when levodopa is used, alone (high incidence) or in combination with bromocriptine (low incidence). The overall optimum treatment is obtained with a combination of L-DOPA/DI and bromocriptine. RESUME: Cet article revoit la litterature sur Feffet therapeutique et le profil des effets secondaires des deux principaux agents dopaminergiques : la L-DOPA associee a un inhibiteur de la decarboxylase (L-DOPA/DI) et la bromocriptine (Parlodel ®) utilises soit comme monotherapie ou en association chez des patients atteints de la maladie de Parkinson. L'association de la L-DOPA/DI avec la bromocriptine produit la meilleure efficacite therapeutique (49% d'amelioration) au niveau du score total (bradykinesie, rigidite et tremblement). Ces traitements presentent le meme profil d'activite, qu'ils soient administres en monotherapie ou en association : la plus grande amelioration est notee au niveau du tremblement suivi de la rigidite et de la bradykinesie. Toutefois, l'amelioration observee a court terme diminue en fonction du temps avec l'un ou l'autre agent administre en monotherapie. Le profil des effets secondaires a court terme est similaire pour les deux traitements, alors que les complications a long terme (dy skinesies, deterioration de fin de dose et phenomene "on-off") n'apparaissent qu'en presence de levodopa, qu'elle soit utilisee seule (incidence elevee) ou en association avec la bromocriptine (incidence faible). L'association de la L-DOPA/DI et la bromocriptine represente le traitement optimal.

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“…17 ' 18 The chronic efficacy of pergolide has been assessed in a small number of studies published recently with conflicting results. Kurlan and his colleagues, 19 using a mean dose of 2.2 mg found that the initial benefit obtained in their 9 late stage patients virtually disappeared by 18 months of therapy. In 7 there was a partial but only temporary restoration of response when the drug was given in an alternate day schedule.…”

Section: Pergolidementioning

confidence: 97%

Update on Dopamine Agonists in Parkinson's Disease: “Beyond Bromocriptine”

Lang

1987

Can. J. Neurol. Sci.

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ABSTRACT:Since the initiation of bromocriptine therapy for Parkinson's disease several newer dopamine agonists have been developed. Pergolide has reached the stage of Phase 3 clinical trials and will probably be available for general use sometime in the foreseeable future. Lisuride shows most promise in its parenteral form for infusion therapy of patients with severe fluctuations. Mesulergine, another ergot-derivative and ciladopa, a new non-ergot agonist, have been withdrawn from further clinical use due to tumorogenesis in rats. It is questionable how applicable these findings are to the use of the drugs in elderly humans with parkinsonism. Recently a small number of drugs have been found to have postsynaptic dopamine agonist properties only in the setting of denervated supersensitive dopamine receptors. These agents may be particularly effective in the early treatment of patients with Parkinson's disease. This paper will review a number of the dopamine agonists which have been developed since the introduction of bromocriptine therapy. Several of these have shown beneficial effects in early clinical trials while others show promise in preclinical studies of animal models of parkinsonism.

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Long‐term experience with pergolide therapy of advanced parkinsonism

Cited by 22 publications

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Essential tremor cured by infarction adjacent to the thalamus.

Essential tremor cured by infarction adjacent to the thalamus.

Optimum Symptomatic Control of Parkinson's Disease with Dopaminergic Therapy

Update on Dopamine Agonists in Parkinson's Disease: “Beyond Bromocriptine”

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