Mirtazapine in L-dopa-induced dyskinesias.
Mirtazapine is a novel antidepressant with a pharmacologic profile (alpha-2 antagonist, 5HT-(1A) agonist, and 5HT-(2) antagonist) that renders it potentially useful for l-dopa-induced dyskinesias. Drugs with 5HT-(1A) agonistic activity, such as buspirone and tandospirone, have been reported to be effective in reducing l-dopa-induced dyskinesias. Furthermore, 5HT-(2) antagonism may, by reducing substantia nigra pars reticulata hyperactivity, play a role in the improvement of Parkinsonian symptoms and l-dopa-induced dyskinesias, as has been observed with ritanserin, a 5HT-(2) antagonist. Alpha-2 antagonists, such as idazoxan, have recently also been reported to improve l-dopa-induced dyskinesias. The authors investigated the antidyskinetic properties of mirtazapine by designing an open-label study of 20 Parkinsonian patients with l-dopa-induced dyskinesias. Mirtazapine proved to be moderately effective in reducing l-dopa-induced dyskinesias, either alone or in association with amantadine. Mirtazapine may be of use in patients who do not respond or are intolerant to amantadine.
Meco
Giuseppe
G
Department of Neurosciences, La Sapienza University, Viale Dell'Universita 30, 00185 Rome, Italy. giuseppe.meco@uniroma1.it
Fabrizio
Edito
E
Di Rezze
Simone
S
Alessandri
Andrea
A
Pratesi
Luca
L
D000368:Aged; D000547:Amantadine / Q000627:therapeutic use; D000704:Analysis of Variance; D004359:Drug Therapy, Combination; D004409:Dyskinesia, Drug-Induced / Q000188:drug therapy*; D006801:Humans; D007980:Levodopa / Q000009:adverse effects*; D008803:Mianserin / Q000031:analogs & derivatives / Q000627:therapeutic use*; D008875:Middle Aged; D000078785:Mirtazapine; D018709:Statistics, Nonparametric
D008803:Mianserin; D007980:Levodopa; D000078785:Mirtazapine; D000547:Amantadine