Apomorphine in the treatment of Parkinson disease and other movement disorders.
BACKGROUND
Apomorphine, a medication that has been studied intensively over the years, is available in the US as intermittent subcutaneous injections for treatment of 'off' motor states in Parkinson disease.


OBJECTIVE
The clinical literature is summarized with particular focus on randomized controlled studies of apomorphine in the treatment of Parkinson disease.


METHODS
After reviewing the pharmacologic properties of apomorphine, the English language literature is summarized with particular attention on articles resulting from a Medline search of apomorphine and Parkinson disease limited to randomized controlled studies. Other formulations and indications for treatment of movement disorders are also discussed.


CONCLUSIONS
Subcutaneous apomorphine is well tolerated when co-administered with trimethobenzamide or domperidone premedication. It has a unique efficacy as a 'rescue' medication owing to its rapid onset of action. Subcutaneous infusion, although not an approved route of administration in the US, provides more continuous dopaminergic stimulation and, therefore, ameliorates dyskinesia and motor fluctuations.
Gunzler
Steven A
SA
Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, The Neurological Institute, Movement Disorders Center, Cleveland, OH 44106, USA. Steven.Gunzler@UHhospitals.org
D000818:Animals; D001058:Apomorphine / Q000737:chemistry / Q000627:therapeutic use*; D006801:Humans; D009069:Movement Disorders / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D016896:Treatment Outcome
D001058:Apomorphine