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An overnight switch to ropinirole therapy in patients with Parkinson's disease. Sixty-eight PD patients with inadequate response to either pergolide (n=46) or bromocriptine (n=22) discontinued their initial dopamine agonist in the evening and commenced ropinirole the next morning. Dose ratios used were 10:6 bromocriptine to ropinirole, and 1:6 pergolide to ropinirole, with slight dose adjustments as needed after the switch. No significant changes in UPDRS scores were seen at the four-week evaluation, except in ADL score, which was significantly improved for patients formerly on bromocriptine. No patient experienced an increase in dopaminergic adverse effects as a result of the switch. The authors conclude, "The results of this study suggest that instantaneous, overnight switching from one dopamine agonist to another may be an effective and well-tolerated therapeutic approach," and note that overnight switching may improve compliance and reduce cost in comparison to slow down-titration and up-titration. M Caesi, A Antonini, CB Mariani, S Tesei, AL Zecchinelli, M Barichella, G Pezzoli J Neural Transmission 1999;106:925-929 Copyright 2000 WE MOVE <http://www.wemove.org> janet paterson 52 now / 41 dx / 37 onset a new voice: http://www.geocities.com/janet313/ 613 256 8340 PO Box 171 Almonte Ontario Canada K0A 1A0