[Bromocriptine as the 1st treatment of Parkinson's disease. Long term results]

Bromocriptine (mean dose: 48 mg daily) was studied during 38 months (mean value) in 20 patients with Parkinson's disease who had never received levodopa treatment. Eight of these 20 patients were treated during a period up to 4 years. Fourteen patients had an "excellent" or "good" improvement with a significant decrease of extrapyramidal symptoms. The side effects were those seen with levodopa but they did not lead to stop the treatment. The most important finding was the lack of long term side effects similar to those usually seen under levodopa treatment: in this group, dyskinesia, oscillations in performance (and specially "on-off" effect) were not noted. A tendency for deterioration of therapeutic efficiency was observed in 2 (or 3) cases. Bromocriptine could be an useful antiparkinsonian drug for previously untreated patients. The pharmacological (importance of the post-synaptic action of bromocriptine) and therapeutic (indications of bromocriptine versus levodopa) implications are discussed.