Low doses of levodopa and bromocriptine in the early management of Parkinson's disease

Abstract:

Early combination therapy with levodopa and bromocriptine is proposed to delay or prevent late complications stemming from a monotherapy scheme with levodopa in Parkinson's disease. In order to assess these complications, we designed a simple-open, double-observer study. We included 23 patients with Parkinson's disease. We set up two groups of patients: Group 1 was comprised of patients with de novo Parkinson's disease, whereas Group 2 was made up patients with Parkinson's disease who had previously received levodopa and/or bromocriptine. We evaluated the therapeutic response and presence of dyskinesias, motor fluctuations, freezing, mental condition, and side effects of the drugs in all the patients at each visit. After treatment, the de novo patients significantly improved the time they remained in 'on' during the day (p < 0.01) and freezing, which was controlled in 50% of cases. In the patients of Group 2, we found significant improvement (p < 0.02) of the Parkinsonian disability in accordance with the evaluation scale of Columbia University, the freezing improved in more than 60% and the dyskinesias in 66.6% of the cases. In the patients of Group 2, the pbkp_redictable motor fluctuations (end-of-dose akinesia) did not improve; in contrast, the unpbkp_redictable motor fluctuations (on-off) and the early-morning and night dystonia did improve. The undesirable effects of the drugs were greater in the patients who had previously received levodopa and/or bromocriptine. Early combination therapy could delay, reduce or prevent motor fluctuations and dyskinesias in patients with de novo Parkinson's disease. In the patients who had previously received levodopa and bromocriptine, the therapeutic scheme improved the dyskinesias and were of little or no benefit for the motor fluctuations.

Año de publicación:

1993

Keywords:

Fuente:

scopus