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Dr. Bob is Robert Hsiung, MD,
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Posted by ed_uk on July 2, 2005, at 1:19:22
Dopamine agonist relieves dyskinesias
Starting younger patients with Parkinson’s disease on a dopamine agonist rather than levodopa pays dividends in the long-term, data from a 10-year study suggest.Researchers followed patients (average age 63 years) who had completed an earlier five-year trial in which they had been randomised to either initial ropinirole (Requip) or levodopa monotherapy. Throughout the 10-year period physicians were free to add in levodopa or other drugs as deemed necessary. By 10 years all patients needed a combination of drugs.
After 10 years, fewer patients in the initial dopamine agonist group had developed dyskinesias than those who started on levodopa (52.4 per cent vs 77.8 per cent). Time to onset of dyskinesia was also longer for the dopamine agonist group.
Commenting on the study, David Brooks, professor of neurology at Imperial College London, said: “I had cynically assumed all the initial dyskinesia-sparing benefits of ropinirole would have been seen in the first five or so years and be lost by 10 years. But it seems people do benefit for at least 10 years from starting with a dopamine agonist.”However, most patients prescribed ropinirole in the UK were getting a suboptimal dosage, Professor Brooks warned. “The average daily dose used by UK GPs is about 6mg whereas in my experience patients on monotherapy need between 9mg and 12mg daily, and often higher, to get a good response.”
Data were presented at the International Congress on Parkinson’s Disease and Related Disorders held in Berlin last month.
Posted by linkadge on July 2, 2005, at 1:19:22
In reply to Dopamine agonists for PD, posted by ed_uk on July 1, 2005, at 12:36:20
Aren't some of these agents neuroprotective.
Makes you wonder if they can spare parkisons's disease progression, what agents in the AD class can spare depression progression.
Linkadge
Posted by mogger on July 2, 2005, at 1:19:22
In reply to Re: Dopamine agonists for PD, posted by linkadge on July 1, 2005, at 16:27:12
what does agonist mean exactly? I see a new serotonin agonist coming out hopefully soon but don't know what that means,
mogger
Posted by linkadge on July 2, 2005, at 1:19:22
In reply to Re: Dopamine agonists for PD, posted by mogger on July 1, 2005, at 18:48:52
An SSRI works by increasing overall serotonin. Ie more serotonin gets to all the receptors. When some of these receptors get more serotonin, nasty side effects start to immerge.
An serotonin/dopamine agonist generally activates only one type of serotonin recptor, and theoretically doesn't activate the bad receptors.
Linkadge
Posted by mogger on July 2, 2005, at 1:19:22
In reply to Re: Dopamine agonists for PD, posted by linkadge on July 1, 2005, at 19:24:16
Thanks linkadge, that is a perfect explanation. Most helpful! take care,
mogger
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