DOPAMINE AGONIST TREATMENT OF FLUCTUATING PARKINSONISM - D-2 (CONTROLLED-RELEASE MK-458) VS COMBINED D-1 AND D-2 (PERGOLIDE)

被引：33

作者：

AHLSKOG, JE ^{[1
]}

MUENTER, MD ^{[1
]}

BAILEY, PA ^{[1
]}

STEVENS, PM ^{[1
]}

机构：

[1] MAYO CLIN SCOTTSDALE,LEE SILVERMAN CTR PARKINSONS DIS & MOVEMENT DISORDERS,NEUROL SECT,SCOTTSDALE,AZ

来源：

ARCHIVES OF NEUROLOGY | 1992年 / 49卷 / 05期

关键词：

D O I：

10.1001/archneur.1992.00530290152026

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Adjunctive treatment with the very potent and selective dopamine D-2 agonist MK-458 (controlled-release formulation) improved the control of parkinsonism in patients with fluctuating responses to levodopa therapy (with carbidopa). We subsequently switched patients to adjunctive treatment with pergolide, a less potent D-2 agonist. Pergolide therapy controlled parkinsonism more effectively than controlled-release MK-458. Unlike MK-458, pergolide mesylate also has D-1 agonist properties, apparently accounting for its greater antiparkinsonism efficacy. Adjunctive treatment with controlled-release MK-458 elicited less choreiform dyskinesias than either pergolide adjunctive therapy or therapy with carbidopa-levodopa alone; this finding suggests that D-1 receptor stimulation contributes to the elicitation of medication-induced chorea. The highest doses of controlled-release MK-458 resulted in paradoxical freezing of gait in almost one third of patients. This finding suggests that gait freezing, common in untreated parkinsonism, can also be elicited by excessive D-2 stimulation.

引用

页码：560 / 568

页数：9