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Bromocriptine in the Management of End of Dose Deterioration in Parkinson’s Disease

Published online by Cambridge University Press:  18 September 2015

J.D. Grimes ,
D.B. King ,
O.S. Kofman ,
P. Molina-Negro ,
A.F. Wilson  and
S. Bouchard
J.D. Grimes*
Affiliation:
the Ottawa Civic Hospital (Dr. Grimes); Victoria General Hospital, Halifax (Dr. King); Mount Sinai Hospital, Toronto (Dr. Kofman); Notre Dame Hospital, Montreal (Dr. Molina-Negro); Royal Alexandra Hospital, Edmonton (Dr. Wilson); Sandoz Canada, Montreal (Dr. Bouchard)
D.B. King
Affiliation:
the Ottawa Civic Hospital (Dr. Grimes); Victoria General Hospital, Halifax (Dr. King); Mount Sinai Hospital, Toronto (Dr. Kofman); Notre Dame Hospital, Montreal (Dr. Molina-Negro); Royal Alexandra Hospital, Edmonton (Dr. Wilson); Sandoz Canada, Montreal (Dr. Bouchard)
O.S. Kofman
Affiliation:
the Ottawa Civic Hospital (Dr. Grimes); Victoria General Hospital, Halifax (Dr. King); Mount Sinai Hospital, Toronto (Dr. Kofman); Notre Dame Hospital, Montreal (Dr. Molina-Negro); Royal Alexandra Hospital, Edmonton (Dr. Wilson); Sandoz Canada, Montreal (Dr. Bouchard)
P. Molina-Negro
Affiliation:
the Ottawa Civic Hospital (Dr. Grimes); Victoria General Hospital, Halifax (Dr. King); Mount Sinai Hospital, Toronto (Dr. Kofman); Notre Dame Hospital, Montreal (Dr. Molina-Negro); Royal Alexandra Hospital, Edmonton (Dr. Wilson); Sandoz Canada, Montreal (Dr. Bouchard)
A.F. Wilson
Affiliation:
the Ottawa Civic Hospital (Dr. Grimes); Victoria General Hospital, Halifax (Dr. King); Mount Sinai Hospital, Toronto (Dr. Kofman); Notre Dame Hospital, Montreal (Dr. Molina-Negro); Royal Alexandra Hospital, Edmonton (Dr. Wilson); Sandoz Canada, Montreal (Dr. Bouchard)
S. Bouchard
Affiliation:
the Ottawa Civic Hospital (Dr. Grimes); Victoria General Hospital, Halifax (Dr. King); Mount Sinai Hospital, Toronto (Dr. Kofman); Notre Dame Hospital, Montreal (Dr. Molina-Negro); Royal Alexandra Hospital, Edmonton (Dr. Wilson); Sandoz Canada, Montreal (Dr. Bouchard)
*
Suite 304, 1081 Carling Ave., Ottawa, Ontario, Canada K1Y 4G2
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Abstract

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Thirty-three patients with advanced Parkinson’s disease complicated by end of dose deterioration were treated with bromocriptine. The drug was slowly increased so that by treatment week 24 the mean daily dose of bromocriptine was 22mg and levodopa had been decreased by an average of 15 percent. The majority of improvement in daily fluctuations and Parkinsonian disability score was documented by 8 weeks, at which time the mean daily bromocriptine dose was only 12mg.

End of dose deterioration was reduced in 78 percent of the patients (mean 43% improvement). Total Parkinsonian disability score was decreased by 33 percent. Adverse effects were minimal; the most common was mild transient early treatment nausea which occurred in 15 percent of the patients.

The slow introduction of small doses of bromocriptine, combined with minimal levodopa reduction, can give Parkinsonian patients significant improvement in end of dose deterioration.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 11 , Issue 4 , November 1984 , pp. 452 - 456
Copyright
Copyright © Canadian Neurological Sciences Federation 1984

References

Barbeau, A. (1971) Long-Term Side-Effects of Levodopa. Lancet 1: 395.CrossRefGoogle ScholarPubMed
Calne, DB., Williams, AC., Neophytides, A., Plotkin, C., Nutt, JG., Teychenne, PF. (1978) Long-term treatment of Parkinsonism with Bromocriptine. Lancet 1: 735–738.CrossRefGoogle ScholarPubMed
Canter, GJ., De La Torre, R., Mier, M. (1961) A method for evaluating disability in patients with Parkinson’s disease. J Nerv Ment Dis 133: 143–147.CrossRefGoogle ScholarPubMed
Duvoisin, RC. (1971) The evaluation of extrapyramidal disease. In: Monoamines noyaux gris centraux et syndrome de parkinson. Eds De Ajuriaguerra, J., Gauthier, G.313–325. Masson, Paris.Google Scholar
Fahn, S. (1982) Fluctuations of disability in Parkinson’s disease: Pathophysiology. Movement Disorders. Eds Marsden, CD. and Fahn, S. 8: 123–145. Butterworth, London.Google Scholar
Glantz, R., Goetz, CG., Nausieda, PA., Weiner, WJ., Klawans, HL. (1981) The effect of Bromocriptine (BCT) on the On-Off Phenomenon. J Neural Transm 52: 41–47.Google Scholar
Granerus, AK. (1978) Factors influencing the occurrence of “on-off” Symptoms during Long-Term Treatment with L-Dopa. Acta Med Scand 203: 75–85.CrossRefGoogle ScholarPubMed
Grimes, JD., Hassan, MN. (1981) Method of Addition of Bromocriptine to the Drug Regime of Patients with Advanced Parkinson’s Disease. Can J Neurol Sci 8: 31–34.CrossRefGoogle Scholar
Grimes, JD., Hassan, MN. (1983) Bromocriptine in the Long-Term Management of Advanced Parkinson’s Disease. Can J Neurol Sci 10: 86–90.CrossRefGoogle ScholarPubMed
Grimes, JD. (1984) Bromocriptine in Parkinson’s Disease: Results Obtained With High and Low Dose Therapy. Can J Neurol Sci 11: 225–228.CrossRefGoogle ScholarPubMed
Hoehn, MM. (1981) Bromocriptine and Its Use in Parkinsonism. J Am Geriatr Soc 29 (6): 251–258.CrossRefGoogle ScholarPubMed
Hoehn, MM., Yahr, MD. (1967) Parkinsonism: Onset, progression, and mortality. Neurology 17: 427–442.CrossRefGoogle ScholarPubMed
Larsen, TA., Newman, RP., LeWitt, PA., Calne, DB. (1983) Bromocriptine Dosage and the Severity of Parkinson’s Disease. Neurology 33 (Suppl 2): 137.Google Scholar
Lees, AJ., Stern, GM. (1983) Sustained Low-Dose Levodopa Therapy in Parkinson’s Disease: A 3-Year Follow-Up. Adv Neurol 37: 9–15.Google ScholarPubMed
Lieberman, AN., Gopinathan, G., Hassouri, H., Neophytides, A., Goldstein, M. (1984) Should Dopamine Agonists Be Given Early or Late? A Review of Nine Years Experience with Bromocriptine. Can J Neurol Sci 11: 233–237.CrossRefGoogle ScholarPubMed
Marsden, CD., Parkes, JD. (1976) “On-Off” Effects in Patients with Parkinson’s Disease on Chronic Levodopa Therapy. Lancet 1: 292–296.CrossRefGoogle ScholarPubMed
Marsden, CD. (1980) “On-Off” Phenomenon in Parkinson’s Disease. Parkinson’s Disease – Current Progress, Problems and Management, Eds Rinne, UK., Klinger, M., Stamm, G. 15: 241–254. Elsevier/North Holland Biomedical Press, Amsterdam.Google Scholar
Marsden, CD., Parkes, JD., Quinn, N. (1982) Fluctuations of disability in Parkinson’s disease – clinical aspects. Movement Disorders. Eds Marsden, CD., and Fahn, S. 7: 96–122. Butterworth, London.Google Scholar
Nutt, JG., Woodward, WR., Hammerstad, JP., Carter, JH., Anderson, JL. (1984) The “On-Off” Phenomenon in Parkinson’s Disease. N Engl J Med 310: 484–488.CrossRefGoogle Scholar
Parkes, JD., Debono, AG., Marsden, CD. (1976) Bromocriptine in Parkinsonism: longterm treatment, dose response, and comparison with levodopa. J Neurol Neurosurg Psychiatry 39: 1101–1108.CrossRefGoogle ScholarPubMed
Parkes, JD. (1979) Drug Therapy: Bromocriptine. N Engl J Med 301: 873–878.Google ScholarPubMed
Quinn, N., Marsden, CD., Parkes, JD. (1982) Complicated Response Fluctuations in Parkinson’s Disease: Response to Intravenous Infusion of Levodopa. Lancet 2: 412–415.CrossRefGoogle ScholarPubMed
Rascol, A., Guiraud, B., Montastruc, JL., David, J., Clanet, M. (1979) Long-term treatment of Parkinson’s disease with bromocriptine. J Neurol Neurosurg Psychiatry 42: 143–150.CrossRefGoogle ScholarPubMed
Shaw, KM., Lees, AJ., Stern, GM. (1980) The Impact of Treatment with Levodopa on Parkinson’s Disease. Quat J Med 49 (195) 283–293.Google ScholarPubMed
Shoulson, I., Glaubiger, GA., Chase, TN. (1975) “On-Off” Response: Clinical and biochemical correlations during oral and intravenous levodopa administration in parkinsonian patients. Neurology 25: 1144–1148.CrossRefGoogle ScholarPubMed
Stern, GM., Lees, AJ. (1983) Sustained Bromocriptine Therapy in 50 Previously Untreated Patients with Parkinson’s Disease. Adv Neurol 37: 17–21.Google ScholarPubMed
Teychenne, PF., Bergsrud, D., Racy, A., Elton, RL., Vern, B. (1982) Bromocriptine: Low-dose therapy in Parkinson disease. Neurology 32: 577–583.CrossRefGoogle ScholarPubMed