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Bromocriptine in the Long-Term Management of Advanced Parkinson’s Disease

Published online by Cambridge University Press:  18 September 2015

J. David Grimes  and
Mohamed N. Hassan
J. David Grimes*
Affiliation:
Parkinson’s Disease Clinic, Division of Neurology, Ottawa Civic Hospital and the University of Ottawa
Mohamed N. Hassan
Affiliation:
Parkinson’s Disease Clinic, Division of Neurology, Ottawa Civic Hospital and the University of Ottawa
*
1081 Carling Ave., Suite 304, Ottawa, Ontario, Canada, K1Y 4G2.
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Thirty-seven patients with advanced Parkinson’s disease who initially tolerated, and responded to bromocriptine therapy were followed for 12 to 50 (mean 28) months. Using a method of gradual increase of bromocriptine, with concomitant levodopa reduction, the peak effect of the drug was apparent by three months, at which time the mean daily dose of bromocriptine was 23.9 mg and Sinemet (levodopa + carbidopa) had been reduced by 34 percent.

Eight patients had sustained improvement without further drug changes for an average of 29 (range 14–50) months. After periods of improvement varying between 3 and 30 months, 29 patients had a fall-off from peak effect. Peak effect was regained in 21 of these 29 patients for an average of 16 additional months by initially increasing bromocriptine or Sinemet, or by eventually increasing both drugs. The main adverse effect was a confusional state which necessitated late withdrawal of bromocriptine in four patients. The best results were in younger patients with end-of-dose deterioration and levodopa induced dyskinesias.

With cautious introduction, and intermittent dosage adjustment, bromocriptine can be of long-term benefit to patients with advanced Parkinson’s disease. The majority of patients have a gradual late fall-off in effect which can frequently be reversed with dosage adjustment.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 10 , Issue 2 , May 1983 , pp. 86 - 90
Copyright
Copyright © Canadian Neurological Sciences Federation 1983

References

Barbeau, A. (1971). Long-term Side-effects of levodopa. Lancet 1:395.CrossRefGoogle ScholarPubMed
Calne, D.B., Teychenne, P.F., Claveria, L.E., Eastman, R., Greenacre, J.K. and Petrie, A. (1974). Bromocriptine in parkinsonism. Br. Med. J. 4:442–444.CrossRefGoogle ScholarPubMed
Calne, D.B., Williams, A.C., Neophytides, A., Plotkin, C., Nutt, J.G., and Teychenne, P.F. (1978). Long-term treatment of parkinsonism with bromocriptine. Lancet 1:735–738.CrossRefGoogle ScholarPubMed
Canter, G.J., De La Torre, R. and Mier, M. (1961). A method for evaluating disability in patients with Parkinson’s disease. J. Nerv. Ment. Dis. 133:143–147.CrossRefGoogle ScholarPubMed
Duvoisin, R.C. (1971). The evaluation of extrapyramidal disease. In: Monoamines noyaux gris centraux et syndrome de parkinson. Eds. De Ajuriaguerra, J., Gauthier, G.. 313–325, Masson, Paris.Google Scholar
Grimes, J.D. and Hassan, M.N. (1981). Method of addition of bromocriptine to the drug regime of patients with advanced Parkinson’s disease. Can. J. Neurol. Sci. 8:31–34.Google Scholar
Hoehn, M.M. and Yahr, M.D. (1967). Parkinsonism: Onset, progression, and mortality. Neurology 17:427–442.CrossRefGoogle ScholarPubMed
LeWitt, P.A. and Calne, D.B. (1981). Recent advances in the treatment of Parkinson’s disease: The role of bromocriptine. J. Neural. Trans. 51:175–184.Google Scholar
Lieberman, A., Dziatolowski, M., Kupersmith, M., et al (1979). Dementia in Parkinson’s disease. Ann. Neurol. 6:355–359.Google Scholar
Lieberman, A., Kupersmith, M., Neophytides, A., et al. (1980). Long-term efficacy of bromocriptine in Parkinson disease. Neurology 30:518–523.Google ScholarPubMed
Marsden, C.D., Parkes, J.D. (1976). On-off effects in patients with Parkinson’s disease on chronic levodopa therapy. Lancet 1:292–296.CrossRefGoogle ScholarPubMed
Rascol, A., Guiraud, B., Montastruc, J.L., David, J. and Clanet, M. (1979). Long-term treatment of Parkinson’s disease with bromocriptine. J. Neurol. Neurosurg. Psychiatry 42:143–150.CrossRefGoogle ScholarPubMed
Rinne, U.K. (1981). Pleuropulmonary changes during long-term bromocriptine treatment for Parkinson’s disease. Lancet 1:44.CrossRefGoogle Scholar
Shaw, K.M., Lees, A.J. and Stern, G.M. (1980). The impact of treatment with levodopa on Parkinson’s disease. Q.J. Med. 49(195):283–293.Google ScholarPubMed
Teychenne, P.F., Bergsrud, D., Racy, A., Elton, R.L. and Vern, B. (1982). Bromocriptine: Low-dose therapy in Parkinson disease. Neurology 32:577–583.CrossRefGoogle ScholarPubMed