title: Pramipexole safely replaces ergot dopamine agonists with either rapid or slow switching.
abstract: This prospective, open-label, multicentre study examined the efficacy and safety of rapidly (overnight) or slowly (after 2 weeks of concomitant usage) switching patients with Parkinson's disease (PD) from conventional ergot dopamine agonists (DAs) to the non-ergot DA, pramipexole. Fifty-nine early-to-advanced PD patients with motor symptoms that were inadequately controlled by ergot DAs were enrolled. Patients were switched from ergot derivatives to pramipexole and evaluated every 2 weeks for 12 weeks by Hoehn and Yahr staging, Unified Parkinson's Disease Rating Scale (UPDRS) and a modified Epworth Sleepiness Scale (mESS). The UPDRS III subscores and total UPDRS scores significantly improved, independent of switching method. Adverse events, all of which were mild, occurred in 29.2% of patients. No sudden onset of excessive daytime sleepiness or significant worsening in mESS was seen. Switching patients with PD from ergot DA to pramipexole, using either a slow or rapid switching method, appeared to be well tolerated and effective, although further dose adjustment may be necessary in some patients after the switch.
authors.affiliation: Division of Neurology, Department of Internal Medicine, Tokai University, Isehara, Kanagawa, Japan. ht1126@is.icc.u-tokai.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Takahashi
authors.forename: S
authors.initials: S
authors.lastname: Nogawa
authors.forename: H
authors.initials: H
authors.lastname: Tachibana
authors.forename: J
authors.initials: J
authors.lastname: Kawamura
authors.forename: T
authors.initials: T
authors.lastname: Abe
authors.forename: Y
authors.initials: Y
authors.lastname: Ogino
authors.forename: K
authors.initials: K
authors.lastname: Kashihara
authors.forename: T
authors.initials: T
authors.lastname: Hamada
authors.forename: H
authors.initials: H
authors.lastname: Kowa
mesh_terms: D000328:Adult; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D052160:Benzothiazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D001971:Bromocriptine / Q000008:administration & dosage / Q000627:therapeutic use; D000077465:Cabergoline; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004873:Ergolines / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D010300:Parkinson Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D010479:Pergolide / Q000008:administration & dosage / Q000627:therapeutic use; D000077487:Pramipexole; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D052160:Benzothiazoles; D018491:Dopamine Agonists; D004873:Ergolines; D010479:Pergolide; D001971:Bromocriptine; D000077487:Pramipexole; D000077465:Cabergoline