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ICPD: High-Dose Pergolide Decreases Need For Levodopa In Parkinson's Disease By Richard Robinson Special to DG News HELSINKI, FINLAND -- July 30, 2001 -- High doses of the dopamine agonist pergolide can substitute for levodopa in patients with Parkinson’s disease. The findings were presented at the 14th International Congress on Parkinson’s Disease in Helsinki, July 27-August 1, 2001. Dopamine agonists are being used increasingly to treat Parkinson’s disease (PD), according to Dr. Johannes Schwarz of the California Institute of Technology and the University of Leipzig. The levodopa-sparing effect of dopamine agonists has been shown to reduce the development of unwanted movements, or dyskinesias, that begin after several years of levodopa use. To test the ability of high doses of pergolide to substitute for levodopa in established PD, Dr. Schwarz and colleagues enrolled 33 patients with mild disease in an open-label study, gradually reducing their levodopa dosage by half and increasing their pergolide dosage four-fold over 24 weeks. Patients had a statistically significant improvement in motor-related symptoms of about 20 percent over the course of the trial, with no changes in dyskinesias or activities of daily living. Twenty-seven patients completed the trial, with drop outs due to lack of efficacy in two cases, and psychosis in one case. Anxiety and hallucinations were seen in about 20 percent of patients, "though this was less than we anticipated," Dr. Schwarz said, based on known adverse events of dopamine agonists. Other adverse events included weakness, abdominal pain and edema. "Many of our patients have remained on high-dose pergolide for several years, now," Dr. Schwarz said, although two have had to scale back their doses due to side effects. The research study, titled, "High-dose therapy with pergolide-results of a prospective randomized trial", was supported by Eli Lilly. E-mail this page to a friend or colleague! To print, use this version