Dopamine agonists in Parkinson’s disease

Abstract

Dopamine agonists are established as effective drugs for the symptomatic treatment of Parkinson’s disease (PD) throughout its course. As monotherapy, they produce effective control of motor symptoms and combine this with a low risk for motor complications. As an adjunct to levodopa, they improve motor control and limit the need for levodopa in those patients in whom this may be considered relevant. The non-ergot dopamine agonists in particular have a good safety profile, although as with other agonists, sedation, and cognitive and behavioral problems may be limiting in some patients. Pramipexole has shown benefit in improving depressive symptoms in PD. Ropinirole and pramipexole have both demonstrated a reduction in the rate of loss of nigrostriatal innervation as determined by imaging in PD patients, when compared with levodopa. Thus, dopamine agonists contribute to several dimensions of the management of PD and have become an integral part of the disease treatment algorithm.

Keywords::

• cardiac valve fibrosis
• depression
• dopamine agonist
• motor complication
• neuroprotection
• Parkinson’s disease

Financial & competing interests disclosure

Anthony Schapira has received honoraria or undertaken consultancy work for Boehringer-Ingelheim, GlaxoSmithKline, Teva-Lundbeck, Orion-Novartis, Schwartz-Pharma and Valeant. Mitsutoshi Yamamoto has received honoraria from Boehringer-Ingelheim. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.