Switch-over from tolcapone to entacapone in severe Parkinson's disease patients.
Forty patients affected by severe Parkinson's disease (PD) were treated with tolcapone as an adjunctive therapy to L-DOPA, for 3-7 months, until this drug was discontinued because of side-effects (2 diarrhoea, one of them with orthostatic hypotension, 2 increments of liver enzymes) or because of mandatory indications of the European drugs authority. All patients, after 3-6 months of L-DOPA therapy adjustments, received entacapone for 3 months again followed by withdrawal. L-DOPA daily dosage was significantly reduced by tolcapone and entacapone (p = 0.01 and 0.05). "On" time was increased by 15% during tolcapone treatment (p < 0.05), and by 8% during entacapone treatment. "Off" time was decreased by 16% during tolcapone and by 7% during entacapone treatment. Entacapone was withdrawn in the same patient who experienced diarrhoea and orthostatic hypotension during tolcapone because of recurrence of side-effects, in 6 patients because of increment of dyskinesias (with hallucinations) and in 1 patients because of rhythmic, jerking myoclonus.
Onofrj
M
M
Department of Oncology and Neuroscience, Neurophysiopathology, University G. D'Annunzio, via Fonte Romano, I-65100 Pescara, Italy. onofrj@phobos.unich.it
Thomas
A
A
Iacono
D
D
Di Iorio
A
A
Bonanni
L
L
D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001577:Benzophenones / Q000009:adverse effects* / Q000627:therapeutic use*; D002396:Catechols / Q000009:adverse effects* / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004409:Dyskinesia, Drug-Induced; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D001523:Mental Disorders / Q000139:chemically induced; D008875:Middle Aged; D009570:Nitriles; D009596:Nitrophenols; D010300:Parkinson Disease / Q000188:drug therapy*; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy; D000077867:Tolcapone
D000978:Antiparkinson Agents; D001577:Benzophenones; D002396:Catechols; D009570:Nitriles; D009596:Nitrophenols; D007980:Levodopa; C071192:entacapone; D000077867:Tolcapone