Experience of pergolide in the treatment of Chinese parkinsonian patients with dose-related fluctuations.
BACKGROUND
To improve dose-related fluctuations in patients with Parkinson's disease, the efficacy of pergolide, a long-acting dopamine receptor agonist, was determined.


METHODS
Using a stringent diagnostic criterion for Parkinson's disease, 20 patients were selected for a short-term open-label trial, and were divided into three groups based on the accuracy of clinical diagnosis.


RESULTS
Nineteen patients completed the study. The mean dosage of pergolide was 2.89 mg per day. The total motor score improved by 34.1% during the "on" period and by 34.8% during the "off" period (p < 0.001). The recorded daily off time decreased from 40.3% to 11.5% (p < 0.001). There was no statistically significant difference in the magnitude of response among different groups of patients; however, patients with shorter duration of illness also received significantly lower dosage of pergolide. Hallucination, worsening of peak-dose dyskinesia, and lowering of blood pressure were major adverse effects. Pergolide could not prevent the occurrence of neuroleptic malignant syndrome in one patient.


CONCLUSIONS
Pergolide is very effective for moderate to advanced Parkinson's disease.
Shan
D E
DE
Neurological Institute, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Yeh
S I
SI
D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D006801:Humans; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D010479:Pergolide / Q000627:therapeutic use*
D000978:Antiparkinson Agents; D003692:Delayed-Action Preparations; D010479:Pergolide