The recent survey of doses of pergolide used for PD is remarkable in
the range required to obtain theerapeutic effects with minimum toxicity.
About 10 months experience of combining sinemet (25/100 mg, 7 times in 12
hours) I have used 0.25-1.25 mg pergolide. Below 0.5 mg p.d. there is no
consistent response; at and above 1 mg elicits increasing fatigue, abdominal
pain, hyperkinesias, and, worst of all: hallucinations. These are rarely
threatening but certainly interrupt continuity of concnentration and
effective cognition. I am sometimes startled by rapidly moving illusions, a
danger to driving.
Thus, pergolide is a useful adjunct to sinemet against dyskinasias
and painful muscle spasms, but the combination has limited thereapeutic
effects. Addition of still other adjunct drugs provides little or no
improvement.
Steven
