Simplification of the initiation of bromocriptine in elderly patients with advanced Parkinson's disease

One hundred and seventy-three parkinsonian patients treated with levodopa entered a randomized multicentre comparison between two introductory schedules for adjuvant bromocriptine. A 2-week placebo run-in was followed by a double-blind 8-week titration phase of bromocriptine up to 15 mg daily, according to the standard seven-step, or a simpler three-step, regimen. They were maintained on this dose for a further 8 weeks and then followed for a further 12 weeks. One hundred and fifty-nine patients completed the placebo run-in period, and 132 completed 16 weeks. No significant differences were found between the standard and simplified regimens for efficacy, side-effects, withdrawals or deaths, nor for any of the clinical or functional assessments. The Webster score improved by 29% and the Cape ADL by 32%. The simpler schedule offers advantages to those elderly parkinsonian patients in whom bromocriptine is added to optimal levodopa dosage.