Comparing bromocriptine effects with levodopa effects on bladder function in Parkinson's disease.
To evaluate the effects of bromocriptine on bladder function in Parkinson's disease (PD) patients and compare these effects with those of (L-dopa). We recruited 8 patients with PD. Urodynamic study (UDS) was performed before and 1 hour after administering 100 mg L-dopa/decarboxylase inhibitor (DCI) and 2.5 hours after administering 7.5 mg bromocriptine. After the bromocriptine administration, urinary urgency aggravated. UDS revealed a decreased bladder volume at which detrusor overactivity (DO) was initiated, a decreased bladder volume at first sensation of bladder filling (FSV) (P < 0.05), an increased maximum Watts Factor value (WFmax) (detrusor contractility), a decreased Abrams-Griffiths (AG) number (urethral obstruction), and a decreased postvoid residual (PVR) (P < 0.01). Similarly, after the L-dopa administration, urinary urgency aggravated. UDS revealed an aggravated DO (P < 0.05), a decreased FSV and bladder capacity (P < 0.01, 0.05), an increased WFmax (P < 0.05), an increased AG number, and a decreased PVR (P < 0.01). A single dose of bromocriptine proved to exacerbate urinary urgency and DO in the storage phase, and improve bladder emptying through increased detrusor contractility and decreased bladder outlet obstruction, within hours. With the exception of bladder outlet obstruction, these effects of bromocriptine are similar to the effects of L-dopa, albeit slightly less pronounced.
Uchiyama
Tomoyuki
T
Department of Neurology, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan. uchiyama@faculty.chiba-u.jp
Sakakibara
Ryuji
R
Yamamoto
Tatsuya
T
Ito
Takashi
T
Yamaguchi
Chiharu
C
Awa
Yusuke
Y
Yano
Masashi
M
Yanagisawa
Mitsuru
M
Kobayashi
Makoto
M
Higuchi
Yoshinori
Y
Ichikawa
Tomohiko
T
Yamanishi
Tomonori
T
Hattori
Takamichi
T
Kuwabara
Satoshi
S
D000368:Aged; D000978:Antiparkinson Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001971:Bromocriptine / Q000494:pharmacology / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006801:Humans; D007980:Levodopa / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D010300:Parkinson Disease / Q000150:complications*; D011446:Prospective Studies; D012212:Rheology / Q000379:methods; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D001745:Urinary Bladder Diseases / Q000188:drug therapy* / Q000209:etiology*; D014563:Urodynamics / Q000187:drug effects
D000978:Antiparkinson Agents; D001971:Bromocriptine; D007980:Levodopa