A study of excessive daytime sleepiness and its clinical significance in three groups of Parkinson's disease patients taking pramipexole, cabergoline and levodopa mono and combination therapy

被引:81
作者
Pal, S
Bhattacharya, KF
Agapito, C
Chaudhuri, KR
机构
[1] Kings Coll Hosp London, Dept Neurol, Hosp Lewisham, Reg Movement Disorders Unit, London SE5 9RS, England
[2] Guys Kings & St Thomas Sch Med, London, England
关键词
sleep attack; dopamine agonist; Parkinson's disease; excessive daytime sleepiness;
D O I
10.1007/s007020170098
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective. To determine if therapy with an ergot and a non-ergot dopamine agonist and levodopa confers an increased risk of excessive daytime sleepiness and secondary "sleep attacks" in Parkinson's disease (PD). Methods. Comparative study of three clinical groups taking, pramipexole (Group 1, n = 19, 8 monotherapy), cabergoline (Group 2, n = 22, 10 monotherapy), and levodopa monotherapy (Group 3, n = 14). Clinical and demographic characteristics, occurrence of "sleep attacks", and assessment of daytime sleepiness [using the Epworth Sleepiness Scale (ESS)], recorded. Results. No patients reported "sleep attacks". Mean ESS scores: Group 1 (pramipexole) 8.0 +/- 4.5 (range 0-16), Group 2 (cabergoline) 8.1 +/- 3.9 (range 0-19), Group 3 (levodopa), 8.1 +/- 5.5 (range 1-18). There was no significant difference between groups (p = 0.897). Scores of greater than or equal to 16 indicating excessive daytime sleepiness (EDS) were evenly distributed throughout treatment groups, particularly in older patients with more advanced disease. Conclusions. a) EDS is not unique to pramipexole therapy and occurs with both cabergoline and levodopa. b) Increasing age, advanced disease, and higher treatment dose appear important predictors for EDS. c) Driving regulations should be reviewed accordingly.
引用
收藏
页码:71 / 77
页数:7
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