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Letter
Long term tolerability of high dose ergoline derived dopamine agonist therapy for the treatment of Parkinson’s disease
  1. P Navan,
  2. P G Bain
  1. Department of Neurosciences, Imperial College, Charing Cross Campus, London, UK
  1. Correspondence to:
 Dr P G Bain, Department of Neurosciences, Imperial College, Charing Cross Hospital, London W6 8RF, UK;
 p.bain{at}ic.ac.uk

https://doi.org/10.1136/jnnp.73.5.602

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    During the past decade new direct acting dopamine agonists (DAs) have become widely deployed for the treatment of the early stages of Parkinson’s disease (PD), because randomised controlled trials (RCT) have demonstrated that their use is associated with a reduced incidence of motor fluctuations and dyskinesias compared to levodopa therapy.1–5 In addition, direct acting DAs have been used in combination with levodopa in the later stages of the disease as levodopa sparing agents, to reduce these side effects.6

    However, published randomised controlled trials of DAs with levodopa have tended to focus on the development of motor fluctuations and dyskinesias as primary end points.1–4 Curiously these studies have also shown that the effect of levodopa on motor function or activities of daily living (measured by Unified Parkinson’s Disease Rating Scale (UPDRS) parts II and III) was superior to that obtained by the DAs, irrespective of whether …

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    Footnotes

    • Competing interests: PN was reimbursed by Pharmacia for attending the XIV International Congress on Parkinson’s disease (Finland, 2001). The authors also conducted two double blind trials comparing the antitremor effects of pergolide with pramipexole, to which Pharmacia freely supplied the masked medications.