HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Poewe, W. Search for Related Content PubMed PubMed Citation Articles by Poewe, W.

Adjuncts to levodopa therapy

Dopamine agonists

From the Department of Neurology, University Hospital Innsbruck, Innsbruck, Austria.

Address correspondence and reprint requests to Dr. Werner Poewe, Department of Neurology, University Hospital Innsbruck, Anichstrasse 35, A6020 Innsbruck, Austria.

Abstract.

The classical role of dopamine agonists in Parkinson's disease (PD) therapy is adjunctive treatment to levodopa once "wearing-off" fluctuations or more malignant types of "on-off" swings have developed. Dopamine agonists reduce the frequency, severity, and duration of "off" periods while allowing the levodopa dose to be reduced. Interest is growing in the role of dopamine agonists as primary monotherapy in PD. Studies of early monotherapy have shown that, even with sustained treatment, drug-induced dyskinesias rarely develop.. However, this approach is successful for more than 3 years in only about 30% of all PD patients. Continuous dopaminergic stimulation via subcutaneous dopamine agonist infusions is being investigated as a way to control levodopa-associated peak-dose dyskinesias. Early combined treatment with levodopa has been suggested as effective while avoiding long-term complications, but the therapy remains controversial. Despite the entry of several new dopamine agonists into clinical practice, the ideal agonist, with long duration of action and efficacy equal to that of levodopa, is still lacking. The clinical pharmacology of dopamine agonists is reviewed.