Fluctuations in motor performance are the major problems in chronic management of Parkinson's disease. Most of these fluctuations reflect the decline of levodopa availability. As a consequence, levodopa dosage might be increased and the interdose interval progressively shortened. The postsynaptic dopamine receptors at this point are exposed to a nonphysiologic shift in dopamine level, which may induce changes at the receptor site and contribute to the appearance of ''on-off'' phenomena and dyskinesias. We compared a group of 18 patients treated for 60 consecutive months with continuous subcutaneous lisuride infusion with a group of 20 patients treated with conventional oral levodopa treatment. The clinical evaluations performed during the study showed in the lisuride group only a worsening of dyskinesias, whereas the other symptoms remained unchanged. In the other group the evaluation scores showed a significant worsening of all long-term treatment complications. The slow-release preparations of levodopa may ensure a more continuous dopaminergic stimulation than standard formulations. However, the use of these compounds is difficult in severely fluctuating patients because the lack of a plasma peak level usually leads to a very long delay before patients turn ''on.'' We studied the pharmacokinetic and clinical effects of the two slow-release preparations of levodopa [Madopar HBS and Sinemet controlled-release (CR)] and a combination of Sinemet CR plus standard Sinemet in 13 fluctuating parkinsonian patients. The results of this study show that the combination of standard Sinemet and Sinemet CR ensures a more prolonged clinical effect with a very short latency to the ''on'' phase.

CLINICAL IMPLICATIONS OF SUSTAINED DOPAMINERGIC STIMULATION / F., Stocchi; P. N., Patsalos; Berardelli, Alfredo; L., Barbato; A., Bonamartini; M., Manfredi; S., Ruggieri. - In: CLINICAL NEUROPHARMACOLOGY. - ISSN 0362-5664. - 17:2(1994), pp. S7-S13. (Intervento presentato al convegno Symposium on Long-Acting Levodopa Preparations in the Management of Parkinsons Disease, at the 11th International Symposium on Parkinsons Disease tenutosi a ROME, ITALY nel MAR 26-30, 1994).

CLINICAL IMPLICATIONS OF SUSTAINED DOPAMINERGIC STIMULATION

BERARDELLI, Alfredo;
1994

Abstract

Fluctuations in motor performance are the major problems in chronic management of Parkinson's disease. Most of these fluctuations reflect the decline of levodopa availability. As a consequence, levodopa dosage might be increased and the interdose interval progressively shortened. The postsynaptic dopamine receptors at this point are exposed to a nonphysiologic shift in dopamine level, which may induce changes at the receptor site and contribute to the appearance of ''on-off'' phenomena and dyskinesias. We compared a group of 18 patients treated for 60 consecutive months with continuous subcutaneous lisuride infusion with a group of 20 patients treated with conventional oral levodopa treatment. The clinical evaluations performed during the study showed in the lisuride group only a worsening of dyskinesias, whereas the other symptoms remained unchanged. In the other group the evaluation scores showed a significant worsening of all long-term treatment complications. The slow-release preparations of levodopa may ensure a more continuous dopaminergic stimulation than standard formulations. However, the use of these compounds is difficult in severely fluctuating patients because the lack of a plasma peak level usually leads to a very long delay before patients turn ''on.'' We studied the pharmacokinetic and clinical effects of the two slow-release preparations of levodopa [Madopar HBS and Sinemet controlled-release (CR)] and a combination of Sinemet CR plus standard Sinemet in 13 fluctuating parkinsonian patients. The results of this study show that the combination of standard Sinemet and Sinemet CR ensures a more prolonged clinical effect with a very short latency to the ''on'' phase.
1994
'on-off' phenomena; levodopa; motor performance; on-off phenomena; parkinson's disease; parkinsons disease
01 Pubblicazione su rivista::01a Articolo in rivista
CLINICAL IMPLICATIONS OF SUSTAINED DOPAMINERGIC STIMULATION / F., Stocchi; P. N., Patsalos; Berardelli, Alfredo; L., Barbato; A., Bonamartini; M., Manfredi; S., Ruggieri. - In: CLINICAL NEUROPHARMACOLOGY. - ISSN 0362-5664. - 17:2(1994), pp. S7-S13. (Intervento presentato al convegno Symposium on Long-Acting Levodopa Preparations in the Management of Parkinsons Disease, at the 11th International Symposium on Parkinsons Disease tenutosi a ROME, ITALY nel MAR 26-30, 1994).
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/422770
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