Document Detail


Early combination therapy (bromocriptine and levodopa) does not prevent motor fluctuations in Parkinson's disease.
MedLine Citation:
PMID:  8423888     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Early combination therapy with bromocriptine (Br) and levodopa (LD) is believed to delay or prevent the onset of late treatment complications typically associated with LD monotherapy in Parkinson's disease (PD). Studies recommending this regimen have been uncontrolled. We evaluated this possibility in a 4-year, double-blind, randomized, parallel group trial comparing Br and LD both alone and in combination in 22 PD patients never before treated with dopaminergic medications. In the group receiving Br monotherapy, 17% had motor fluctuations (end-of-dose failure or on-off), 17% chorea, 33% dystonia, and 83% freezing. In the LD group, 33% had motor fluctuations, 56% chorea, 100% dystonia, and 22% freezing. In the combination group, 71% had motor fluctuations, 57% chorea, 71% dystonia, and 57% freezing. The frequency of dystonia was significantly lower with Br monotherapy than in the other two treatment groups. No other significant differences were observed. LD monotherapy appeared to have superior efficacy in the treatment of PD. Mean final doses of LD and Br were similar for the different treatment groups. Early combination therapy does not prevent or delay the onset of motor fluctuations or dyskinesia in PD.
Authors:
W J Weiner; S A Factor; J R Sanchez-Ramos; C Singer; C Sheldon; L Cornelius; A Ingenito
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurology     Volume:  43     ISSN:  0028-3878     ISO Abbreviation:  Neurology     Publication Date:  1993 Jan 
Date Detail:
Created Date:  1993-02-23     Completed Date:  1993-02-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  21-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, University of Miami School of Medicine, FL 33101.
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Aged
Bromocriptine / administration & dosage*
Chorea / prevention & control
Double-Blind Method
Drug Therapy, Combination
Dystonia / prevention & control
Female
Humans
Levodopa / administration & dosage*
Male
Middle Aged
Motor Skills / drug effects*
Parkinson Disease / drug therapy*
Chemical
Reg. No./Substance:
0/Levodopa; 25614-03-3/Bromocriptine
Comments/Corrections
Comment In:
Neurology. 1993 Dec;43(12):2725; author reply 2726-7   [PMID:  8255490 ]
Neurology. 1993 Dec;43(12):2725-6; author reply 2726-7   [PMID:  8255491 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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