Parkinson’s disease: The proper use of dopamine receptor agonists

Although dopamine receptor agonists are not simple to use, they are assuming increased importance in the treatment of early and advanced symptoms of Parkinson’s disease (PD). The new agonists, pramipexole and ropinirole, are generally adequate without levodopa for early symptoms and carry the hope for a more acceptable profile of long-term side effects. In the patient with advanced disease, all four dopamine agonists significantly augment th response to levodopa, which reduces the problems of motor fluctuations and drug-related dyskinesia. Understanding the common pitfalls when prescribing these drugs will facilitate their safety and efficacy.