Bromocriptine and lisuride in Parkinson disease

Area of Science:

• Neurology
• Pharmacology

Background:

• Parkinson disease (PD) management often involves levodopa.
• Advanced PD can lead to diminished levodopa response, including "wearing off" and "on-off" phenomena.
• Alternative or adjunctive therapies are crucial for managing these complex motor fluctuations.

Purpose of the Study:

• To compare the efficacy and tolerability of lisuride and bromocriptine as adjuncts to levodopa in patients with advanced Parkinson disease.
• To evaluate the impact of these dopaminergic agonists on motor function and "off" time.

Main Methods:

• A comparative study involving 25 patients with Parkinson disease and diminished levodopa response.
• Patients received either bromocriptine or lisuride as an add-on therapy to levodopa.
• Outcomes assessed included changes in disability, "on" time, and adverse events.

Main Results:

• Both bromocriptine and lisuride significantly reduced disability and increased "on" time in patients with advanced Parkinson disease.
• Bromocriptine was discontinued in 11 patients due to adverse effects and in 14 due to decreased efficacy.
• Lisuride was discontinued in 8 patients due to adverse effects.
• Despite similar efficacy in improving motor symptoms, patient populations differed in age, disease duration, and baseline disability at drug initiation.

Conclusions:

• Both bromocriptine and lisuride are effective in managing advanced Parkinson disease patients experiencing diminished levodopa response.
• Adverse effects and decreased efficacy were noted for both agents, impacting long-term use.
• The choice between bromocriptine and lisuride may ultimately depend on individual patient tolerance, specific adverse event profiles, and cost-effectiveness.