Pergolide-induced ergotism

Morgan, John C.; Sethi, Kapil D.

doi:10.1212/01.wnl.0000227185.81250.0f

Cited by 7 publications

(3 citation statements)

References 28 publications

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“…308 -311 However, their use has markedly declined due to the risk of AEs and the introduction of nonergot dopamine agonists. Although Frank ergotism is rare, 312 cardiac dysfunction with valvular thickening and fibrosis has now been reported with pergolide and cabergoline, presumably because they activate the 5HT2b receptor. [313][314][315] As a consequence, pergolide has been voluntarily withdrawn from the market, and the use of cabergoline has markedly declined.…”

Section: No Dyskinesias Up To 6 Monthsmentioning

confidence: 99%

The scientific and clinical basis for the treatment of Parkinson disease (2009)

Olanow¹,

Stern²,

Sethi³

2009

Neurology

771

658

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Parkinson disease (PD) is an age-related neurodegenerative disorder that affects as many as 1-2% of persons aged 60 years and older. With the aging of the population, the frequency of PD is expected to increase dramatically in the coming decades. Current therapy is largely based on a dopamine replacement strategy, primarily using the dopamine precursor levodopa. However, chronic treatment is associated with the development of motor complications, and the disease is inexorably progressive. Further, advancing disease is associated with the emergence of features such as freezing, falling, and dementia which are not adequately controlled with dopaminergic therapies. Indeed, it is now appreciated that these nondopaminergic features are common and the major source of disability for patients with advanced disease. Many different therapeutic agents and treatment strategies have been evaluated over the past several years to try and address these unmet medical needs, and many promising approaches are currently being tested in the laboratory and in the clinic. As a result, there are now many new therapies and strategic approaches available for the treatment of the different stages of PD, with which the treating physician must be familiar in order to provide patients with optimal care. This monograph provides an overview of the management of PD patients, with an emphasis on pathophysiology, and the results of recent clinical trials. It is intended to provide physicians with an understanding of the different treatment options that are available for managing the different stages of the disease and the scientific rationale of the different approaches. 1 PD is the second most common neurodegenerative disorder, with an average age at onset of about 60 years. An estimated 5 million people throughout the world have PD, with 1 million individuals each in the United States and in Europe with the disorder. PD affects approximately 0.3% of the population and 1% to 2% of those older than 60 years.2 With the aging of the population and the substantial increase in the number of at-risk individuals older than 60 years, it is anticipated that the prevalence of PD will increase dramatically in the coming decades.

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Section: No Dyskinesias Up To 6 Monthsmentioning

confidence: 99%

The scientific and clinical basis for the treatment of Parkinson disease (2009)

Olanow¹,

Stern²,

Sethi³

2009

Neurology

771

658

View full text Add to dashboard Cite

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“…However, their use has markedly declined due to the risk of valvular fibrosis and the introduction of nonergot dopamine agonists (apomorfine, pramipexole, ropinirole, rotigotine, piribedil). Although rare, cardiac dysfunction with valvular thickening and fibrosis has been reported with pergolide and cabergoline, presumably because they activate the 5HT2b receptor (Morgan and Sethi 2006;Zanettini et al, 2007;Roth BL 2007). In the nineties, nonergot dopamine agonists have largely supplanted the ergot agonists as the dopamine agonists of choice for the treatment of PD.…”

Section: Dopamine Agonistmentioning

confidence: 99%

Mechanisms of Parkinson's Disease

Hewitt

Whitworth

2017

Current Topics in Developmental Biology

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The power of Drosophila genetics has attracted attention in tackling important biomedical challenges such as the understanding and prevention of neurodegenerative diseases. Parkinson's disease (PD) is the most common neurodegenerative movement disorder which results from the relentless degeneration of midbrain dopaminergic neurons. Over the past two decades tremendous advances have been made in identifying genes responsible for inherited forms of PD. The ease of genetic manipulation in Drosophila has spurred the development of numerous models of PD, including expression of human genes carrying pathogenic mutations or the targeted mutation of conserved orthologs. The genetic and cellular analysis of these models is beginning to reveal fundamental insights into the pathogenic mechanisms. Numerous pathways and processes are disrupted in these models but some common themes are emerging. These often implicate aberrant synaptic function, protein aggregation, autophagy, oxidative stress, and mitochondrial dysfunction. Moreover, an impressive list of small molecule compounds have been identified as effective in reversing pathogenic phenotypes, paving the way to explore these for therapeutic interventions.

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“…A 72-year-old woman with Parkinson disease had been taking pergolide ( Permax ) for about 2 months when she presented to her neurologist with tingling and blue discoloration of her fingers and toes. 4 She had been taking pergolide at a dosage of 8 mg daily “to avoid severe levodopa-induced dyskinesias.” The physician diagnosed the patient with ergotism and switched the pergolide to the nonergot dopamine agonist ropinirole. Within 1 week, the discoloration of the woman's fingers improved and it was completely resolved in 3 months.…”

Section: Pergolide-induced Ergotismmentioning

confidence: 99%

ADRs in a Community Hospital – Do These Numbers Look like Yours?; A Gaggle of “Dermatologic” Reactions – TEN, Iodide Mumps, Doxycycline Phototoxicity; Pergolide-Induced Ergotism; Acute Coronary Syndrome Due to Fluorouracil Infusion; Aripiprazole-Induced Acute Dystonic Reaction; Meta-Analysis: Cardiovascular Events and NSAIDs; More on Dopamine Agonists and Impulse Control Disorders

Shuster¹

2006

Hosp Pharm

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Pergolide-induced ergotism

Cited by 7 publications

References 28 publications

The scientific and clinical basis for the treatment of Parkinson disease (2009)

The scientific and clinical basis for the treatment of Parkinson disease (2009)

Mechanisms of Parkinson's Disease

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