A review of pramipexole and its clinical utility in Parkinson's disease.
Parkinson's disease (PD) is a common neurodegenerative disorder characterised by selective loss of dopaminergic neurones in the substantia nigra and resulting in progressive disability. Therapy has focused on replacing depleted dopamine (DA) via supplementation with levodopa or DA agonists. Pramipexole (Mirapex), Pharmacia Corp.) has recently been approved for the treatment of PD. Evidence from preclinical studies and clinical trials have proven the effectiveness of this agent in ameliorating the symptoms of PD. There is also non-human evidence that pramipexole may be neuroprotective and could therefore possibly slow disease progression; however, this has yet to be proven in humans. The use of pramipexole may be limited by its side effect profile compared to standard therapies and its relatively higher cost compared to levodopa. Despite these concerns, pramipexole does have a role in the treatment of PD in all stages of the illness and may arguably be the treatment of choice in early disease. In addition to its use in PD, pramipexole has shown some utility in the treatment of restless legs syndrome (RLS), depression and schizophrenia.
Biglan
Kevin M
KM
University of Rochester, Department of Neurology, 1351 Mt. Hope Avenue, Suite 220, Rochester, NY 14620, USA. Kbiglan@mct.rochester.edu
Holloway
Robert G
RG
D000818:Animals; D052160:Benzothiazoles; D018491:Dopamine Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007024:Hypotension, Orthostatic / Q000139:chemically induced; D010300:Parkinson Disease / Q000188:drug therapy*; D000077487:Pramipexole; D016032:Randomized Controlled Trials as Topic; D012893:Sleep Wake Disorders / Q000139:chemically induced; D013844:Thiazoles / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D052160:Benzothiazoles; D018491:Dopamine Agonists; D013844:Thiazoles; D000077487:Pramipexole