[Subcutaneous apomorphine in the treatment of Parkinson's disease]

Motor and psychiatric complications are the main limitations for chronic treatment with levodopa in patients with Parkinson's disease (PD). Apomorphine (APM) is a potent D1 and D2 dopaminergic agonist that has been proven useful in the management of PD. Ten patients with complicated PD involving fluctuations in mobility and dyskinesia were treated with subcutaneous APM (1 with continuous infusion and 9 with multiple injections). The patient with continuous infusion experienced an initial stabilization of the motor reaction but treatment had to be stopped due to decrease of efficacy and appearance of local side effects. Of the 9 patients who began it with multiple injections of APM, 5 abandoned it due to various side effects. The remaining patients continued in the study for a mean time of 14.3 months, experiencing a clear clinical improvement. Subcutaneous APM is a useful therapeutic alternative for some patients with complicated PD.