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Related Experiment Videos

Continuous dopaminergic stimulation in Parkinson's disease.

J A Obeso1, M R Luquin, J Vaamonde

  • 1Department of Neurology, University of Navarra, Medical School, Pamploma, Spain.

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
|August 1, 1987
PubMed
Summary

Parenteral administration of levodopa and dopamine agonists effectively manages Parkinson's disease motor fluctuations. However, adverse effects limit routine use, necessitating further research into optimal treatment strategies.

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Area of Science:

  • Neurology
  • Pharmacology

Background:

  • Parkinson's disease (PD) is characterized by complex motor fluctuations and dyskinesias, often termed the "on-off" phenomenon.
  • Parenteral administration of certain medications can correct these motor symptoms.

Purpose of the Study:

  • To review the efficacy and limitations of parenteral administration of levodopa, levodopa-methyl-ester, lisuride, and apomorphine for managing Parkinson's disease motor fluctuations.

Main Methods:

  • Review of existing literature on parenteral drug administration for Parkinson's disease.
  • Analysis of intravenous levodopa infusions and subcutaneous lisuride and apomorphine administration.
  • Evaluation of therapeutic outcomes and adverse effects.

Main Results:

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  • Intravenous levodopa and levodopa-methyl-ester are options due to low solubility, with wearable pumps showing good short-term results.
  • Subcutaneous lisuride and apomorphine are readily absorbed.
  • Subcutaneous lisuride infusion, combined with oral levodopa, effectively controls "on-off" effects in most patients, but psychiatric side effects are a major limitation.
  • Subcutaneous apomorphine infusion is valuable for research but unlikely as a standard therapy.

    • Conclusions:

    • Parenteral administration, particularly continuous subcutaneous lisuride infusion, offers a viable strategy for managing Parkinson's disease motor fluctuations.
    • Adverse effects, especially psychiatric complications with lisuride, restrict its widespread clinical application.
    • Further research is needed to optimize parenteral therapies and understand the pathophysiology of motor fluctuations in Parkinson's disease.