[High dosage therapy of Parkinson disease. New dopamine agonist pramipexol allows reduction of L-dopa dose down to zero].
We report a 63-years old patient with Parkinson's disease, who experienced slight fluctuations 10 years after first signs of the disease and two years after initiation of levodopa/carbidopa and biperiden therapy. He was enrolled in a double blind, placebo controlled study with the dopamine agonist pramipexole. This study was extended to an open phase. During this phase we were able to reduce levodopa/carbidopa down to zero, while fluctuations and peak dose dyskinesias ceased. The most important adverse event were hypersomnia and very slight persistent dyskinesias, which were reported tolerable by the patient. Treatment without levodopa/carbidopa could be maintained for 31 months. We conclude that in selected cases patients in Hoehn and Yahrs stages II to III and with mild fluctuations might be treated with pramipexole without levodopa.
Arnold
G
G
Neurologische Klinik und Poliklinik des Universitätsklinikums Charité, Humboldt-Universität, Berlin.
Kupsch
A
A
D000978:Antiparkinson Agents / Q000008:administration & dosage* / Q000009:adverse effects; D052160:Benzothiazoles; D002230:Carbidopa / Q000008:administration & dosage / Q000009:adverse effects; D018491:Dopamine Agonists / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000187:drug effects; D010300:Parkinson Disease / Q000175:diagnosis / Q000188:drug therapy*; D000077487:Pramipexole; D013844:Thiazoles / Q000008:administration & dosage* / Q000009:adverse effects
D000978:Antiparkinson Agents; D052160:Benzothiazoles; D018491:Dopamine Agonists; D013844:Thiazoles; D007980:Levodopa; D000077487:Pramipexole; D002230:Carbidopa