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Bromocriptine in the Long-Term Management of Advanced Parkinson’s Disease

Published online by Cambridge University Press:  18 September 2015

J. David Grimes  and
Mohamed N. Hassan
J. David Grimes*
Affiliation:
Parkinson’s Disease Clinic, Division of Neurology, Ottawa Civic Hospital and the University of Ottawa
Mohamed N. Hassan
Affiliation:
Parkinson’s Disease Clinic, Division of Neurology, Ottawa Civic Hospital and the University of Ottawa
*
1081 Carling Ave., Suite 304, Ottawa, Ontario, Canada, K1Y 4G2.
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Thirty-seven patients with advanced Parkinson’s disease who initially tolerated, and responded to bromocriptine therapy were followed for 12 to 50 (mean 28) months. Using a method of gradual increase of bromocriptine, with concomitant levodopa reduction, the peak effect of the drug was apparent by three months, at which time the mean daily dose of bromocriptine was 23.9 mg and Sinemet (levodopa + carbidopa) had been reduced by 34 percent.

Eight patients had sustained improvement without further drug changes for an average of 29 (range 14–50) months. After periods of improvement varying between 3 and 30 months, 29 patients had a fall-off from peak effect. Peak effect was regained in 21 of these 29 patients for an average of 16 additional months by initially increasing bromocriptine or Sinemet, or by eventually increasing both drugs. The main adverse effect was a confusional state which necessitated late withdrawal of bromocriptine in four patients. The best results were in younger patients with end-of-dose deterioration and levodopa induced dyskinesias.

With cautious introduction, and intermittent dosage adjustment, bromocriptine can be of long-term benefit to patients with advanced Parkinson’s disease. The majority of patients have a gradual late fall-off in effect which can frequently be reversed with dosage adjustment.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 10 , Issue 2 , May 1983 , pp. 86 - 90
Copyright
Copyright © Canadian Neurological Sciences Federation 1983

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