title: Rotigotine for anxiety during wearing-off in Parkinson's disease with dementia.
abstract: BACKGROUND
  Wearing-off (WO) refers to the exacerbation of motor and/or non-motor symptoms of Parkinson's disease at the end of dose of dopaminergic medications. Treatment of WO is based on modifying drug schedule, meal timetable and/or increasing dopamine replacement therapy. In advanced and/or demented patients, management of WO is often limited by scarce compliance and by cognitive, psychiatric and dysautonomic side-effects that may accompany increased dopaminergic stimulation.
  
  
  METHODS
  Here, we report 2 patients suffering from Parkinson's disease with dementia, who experienced anxiety as non-motor symptom of WO under stable levodopa therapy. In both cases, transdermal rotigotine (4 mg/day) was added to the original dopaminergic therapy.
  
  
  RESULTS
  Rotigotine proved beneficial on symptoms of anxiety in both patients, without worsening cognitive and behavioral symptoms. During the 9-month follow-up period, there was a slight improvement of motor impairment, with no worsening of drug-related dyskinesia.
  
  
  CONCLUSIONS
  These preliminary results suggest that rotigotine at low dose might improve non-motor symptoms of WO in elderly patients suffering from Parkinson's disease with dementia, without raising major safety issues.
authors.affiliation: Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso - NeSMOS, "Sapienza" Università di Roma, Via di Grottarossa, 1035, 00189, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Fanciulli
authors.forename: Francesca
authors.initials: F
authors.lastname: Assogna
authors.forename: Carlo
authors.initials: C
authors.lastname: Caltagirone
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Spalletta
authors.forename: Francesco E
authors.initials: FE
authors.lastname: Pontieri
mesh_terms: D000368:Aged; D001007:Anxiety / Q000188:drug therapy*; D003704:Dementia / Q000188:drug therapy*; D018491:Dopamine Agonists / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D010300:Parkinson Disease / Q000188:drug therapy*; D013764:Tetrahydronaphthalenes / Q000627:therapeutic use*; D013876:Thiophenes / Q000627:therapeutic use*
chemical_list: D018491:Dopamine Agonists; D013764:Tetrahydronaphthalenes; D013876:Thiophenes; C047508:rotigotine