[Apomorphine for treatment of "off-periods" in Parkinson's disease].
After 3-5 years of continuous use of 1-dopa preparations for Parkinson's disease, 25%-50% of patients develop side-effects such as the "on-off" phenomenon and involuntary movements that markedly impair function. One cause of these manifestations is evidently a disturbance in the absorption of 1-dopa. We attempted to avoid this problem by using subcutaneous injections. Apomorphine is a rapid-acting dopamine agonist which causes a return from "off" to "on" within minutes. We present the results of a trial of subcutaneous injections of apomorphine in 22 Parkinsonian patients (12 males, 10 females) with severe motor fluctuations. During 5 days prior to the apomorphine all received Motilium (domperidone, 60 mg/d) to prevent nausea and vomiting. All were hospitalized initially to determine optimal dosage and to teach them the technique of self-injection. 2 to 4 mg of apomorphine were injected 1 to 3 times daily for 2 to 12 months. In 17 patients (80%) "off" periods were reduced without significant side-effects. Apomorphine seems to be effective, tolerable treatment for shortening 1-dopa induced "off" periods.
Zoldan
J
J
Dept. of Neurology, Rabin Medical Center, Petah Tikva.
Merims
D
D
Kuritzky
A
A
Ziv
I
I
Melamed
E
E
D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001058:Apomorphine / Q000008:administration & dosage / Q000627:therapeutic use*; D004294:Domperidone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D007980:Levodopa / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000517:prevention & control; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology; D014839:Vomiting / Q000517:prevention & control
D000978:Antiparkinson Agents; D007980:Levodopa; D004294:Domperidone; D001058:Apomorphine