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Agonist substitution in advanced Parkinson's disease
C G Goetz1, K M Shannon, C M Tanner
1Department of Neurological Sciences, Rush Presbyterian St. Luke's Medical Center, Chicago, IL 60612.
Neurology
|August 1, 1989
Summary
Parkinson's disease patients switching from pergolide (PERG) to bromocriptine (BCT) showed no significant motor improvement. However, patients remained stable, and some experienced trends toward better "on" time without significant side effects.
Area of Science:
- Neurology
- Movement Disorders
- Pharmacology
Background:
- Pergolide (PERG) is a dopamine agonist used for Parkinson's disease (PD).
- Loss of efficacy with PERG necessitates alternative treatment strategies.
- Dopamine agonists like bromocriptine (BCT) are considered for PD management.
Purpose of the Study:
- To evaluate the efficacy of bromocriptine (BCT) therapy in Parkinson's disease (PD) patients who lost response to pergolide (PERG).
- To assess motor function and "on/off" time changes after switching from PERG to BCT.
Main Methods:
- A cohort of 11 Parkinson's disease (PD) patients was studied.
- Paired t-tests compared motor scores at baseline (on PERG) and after 6 months of BCT therapy.
- "On/off" time data were collected for a subset of patients.
Main Results:
- No statistically significant improvement in motor scores was observed after switching to BCT therapy.
- Patients on BCT therapy remained clinically stable.
- A trend towards decreased "off" time and increased "on" time without chorea was noted but not statistically significant.
- The side effect profiles of PERG and BCT were comparable.
Conclusions:
- Bromocriptine (BCT) may not provide significant motor benefit for Parkinson's disease (PD) patients experiencing loss of efficacy with pergolide (PERG).
- BCT therapy appears to maintain stability in this patient population.
- Further research may be needed to explore alternative dopaminergic therapies for PD patients with waning PERG response.