title: Piribedil: its synergistic effect in multidrug regimens for parkinsonism.
abstract: Piribedil, a dopamine agonist, was administered to 13 patients with long-standing Parkinson's disease whose major symptoms were not well controlled on levodopa, anticholinergics, alpha-methyldopa, amantadine, or a combination of these agents. Twelve of the 13 clearly benefited from the addition of Piribedil although side effects precluded long term use in two cases. Beneficial results were obtained by using a combination of Piribedil, levodopa, and anticholinergic drugs. Side effects (hallucinations, confusion, dyskinesias) were frequent, but were usually reversible by lowering the dosage of levodopa or the accompanying anticholinergic medication. The synergistic effect of Piribedil and other antiparkinsonian drugs emphasizes the need for careful titration of all available medications in difficult cases and demonstrates the usefulness of dopamine receptor stimulators when drugs acting presynaptically have failed.
mesh_terms: D000368:Aged; D000547:Amantadine / Q000627:therapeutic use; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008750:Methyldopa / Q000627:therapeutic use; D008875:Middle Aged; D009069:Movement Disorders / Q000139:chemically induced; D010276:Parasympatholytics / Q000627:therapeutic use; D010300:Parkinson Disease / Q000188:drug therapy*; D010879:Piperazines / Q000627:therapeutic use*; D010891:Piribedil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D010276:Parasympatholytics; D010879:Piperazines; D007980:Levodopa; D008750:Methyldopa; D000547:Amantadine; D010891:Piribedil