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Optimum Symptomatic Control of Parkinson's Disease with Dopaminergic Therapy

Published online by Cambridge University Press:  05 January 2016

Sylvie Bouchard
Sylvie Bouchard*
Affiliation:
Division of Central Nervous System, Clinical Research Department, SANDOZ Pharmaceuticals, Montreal
*
Laboratoires SANDOZ S.A.R.L., 14. Boulevard Richelieu, 92506 Rueil Malmaison Cedex, France
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Abstract:

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This paper presents a review of the literature on the therapeutic action and the side effects of the two main dopaminergic agents: L-DOPA/decarboxylase inhibitor (L-DOPA/DI) and bromocriptine (Parlodel ®) used either as monotherapy or in combination in patients with Parkinson's disease. The combination of L-DOPA/DI and bromocriptine gives the best therapeutic efficacy (49% improvement) in the total score (bradykinesia, rigidity and tremor). However, treatment by monotherapy or combination gives the same pattern of activity: greatest improvement in tremor, followed by rigidity and bradykinesia. Improvement observed in the short term is not sustained over longer periods of time for monotherapy with either drug. The short-term side effects are similar for each treatment, whereas long-term complications (dyskinesia, end-of-dose deterioration and on-off phenomenon) appear only when levodopa is used, alone (high incidence) or in combination with bromocriptine (low incidence). The overall optimum treatment is obtained with a combination of L-DOPA/DI and bromocriptine.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 14 , Issue S3 , August 1987 , pp. 460 - 465
Copyright
Copyright © Canadian Neurological Sciences Federation 1987

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