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Sublingual apomorphine solution in Parkinson's disease.
P K Panegyres1, S J Graham, B K Williams
1Department of Neurology, Westmead Hospital, NSW.
The Medical Journal of Australia
|September 16, 1991
Summary
Sublingual apomorphine offers rapid relief for Parkinson's disease "off" periods, with faster onset but shorter duration than levodopa. This study compared oral levodopa, subcutaneous, and sublingual apomorphine in Parkinson's patients.
Area of Science:
- Neurology
- Pharmacology
Background:
- Idiopathic Parkinson's disease (PD) is characterized by motor fluctuations, including "end of dose deterioration."
- Levodopa is a primary treatment, but its effectiveness can wane between doses.
Purpose of the Study:
- To compare the efficacy, onset, and duration of single doses of oral levodopa, subcutaneous apomorphine, and sublingual apomorphine.
- To evaluate these treatments in patients experiencing "end of dose deterioration" in Parkinson's disease.
Main Methods:
- A single-blind, placebo-controlled comparative study.
- Five patients with idiopathic Parkinson's disease received domperidone to mitigate nausea.
- Treatments administered included oral levodopa, subcutaneous apomorphine (1-3 mg), and sublingual apomorphine (10-30 mg).
Main Results:
- Maximal efficacy across all three treatments was comparable.
- Both subcutaneous and sublingual apomorphine demonstrated a significantly faster onset of effect compared to oral levodopa.
- However, the duration of effect for both apomorphine formulations was also significantly shorter than that of levodopa.
Conclusions:
- Sublingual apomorphine presents a practical option for quickly alleviating "off" periods in Parkinson's disease patients undergoing long-term levodopa therapy.
- Apomorphine's rapid onset may be beneficial for acute symptom management, despite its shorter duration.