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[Apomorphine in Parkinson disease].

N E Gilhus1

  • 1Nevrologisk avdeling, Haukeland sykehus, Bergen.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|October 30, 1991
PubMed
Summary

Apomorphine injections effectively reduced off-time in Parkinson's disease patients with significant motor fluctuations. This dopamine agonist showed particular benefit for those experiencing end-of-dose failure and marked on-off phenomena.

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Area of Science:

  • Neurology
  • Pharmacology

Background:

  • Parkinson's disease is a progressive neurodegenerative disorder.
  • Motor fluctuations, including on-off phenomena and end-of-dose failure, significantly impact patient quality of life despite optimal levodopa treatment.

Purpose of the Study:

  • To evaluate the efficacy of apomorphine as a subcutaneous injection for managing motor fluctuations in Parkinson's disease.
  • To assess the diagnostic utility of apomorphine testing to guide levodopa therapy adjustments.

Main Methods:

  • A total of 28 patients with parkinsonism received apomorphine via repeated subcutaneous injections between August 1990 and August 1991.
  • Thirteen patients with Parkinson's disease (duration >10 years) received apomorphine treatment, alongside optimal levodopa.
  • Fifteen patients underwent apomorphine testing for diagnostic purposes to evaluate levodopa treatment responsiveness.

Main Results:

  • Apomorphine demonstrated a very good effect in 8 out of 13 treated patients, significantly reducing 'off' time.
  • The most pronounced benefits were observed in patients with marked on-off phenomena and end-of-dose failure, minimal dyskinesias during 'on' periods, and no mental side effects.
  • Apomorphine testing was positive in 3 patients, leading to levodopa initiation in one and dose increase in two; the remaining 12 had negative tests and did not resume levodopa.

Conclusions:

  • Subcutaneous apomorphine injections can be a highly effective treatment for reducing motor fluctuations in advanced Parkinson's disease patients with significant on-off phenomena.
  • Apomorphine testing serves as a valuable diagnostic tool to guide therapeutic decisions regarding levodopa treatment in Parkinson's disease.

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