The latest United Parkinson Foundation newsletter (1996, #3)
contained a report on the Fourth International Congress of
Movement Disorders, held in Vienna, in June. A number of speakers
(Drs. Warren Olanow, Kathleen Shannon and Wolfgang Oertel, among
them) discussed the role of new dopamine agonists, specifically
pramipexole and ropinirole, in postponing levodopa therapy in
early stage PD patients.
"Dr. Kathleen M. Shannon summarized the results of a multi-
center, randomized, double-blind trial of the drug in 335
patients not on levodopa. Pramipexole proved its levodopa-sparing
effect as a symptomatic drug, with only nausea, constipation and
insomnia reported at a 10% higher incidence rate compared with
these effects in patients on placebo."
"Dr. Oertel (Marburg) suggested that new longer-lasting
agonists should be the first line of therapy, especially in
younger-onset patients, taking the agonists to high dosages as
better symptomatic control is needed. As a general rule, when an
individual requires symptomatic treatment, he would start
patients diagnosed under age 60 on agonists, those diagnosed over
age 60 on levodopa."
Dr. Peter Jenner (London) reported on primate studies which
found bromocriptine and ropinirole as effective as levodopa in
reducing disability scores, with lower dyskinesia scores.
(Ropinirole is nearing approval stage.) Dr. Olanow called for
further trials of levodopa versus an agonist both in low and "as
high as you can go dosages."
Those wishing to read the entire very informative report can
contact UPF, 833 West Washington Boulevard, Chicago, Ill. 60607
(312-733-1893) to receive a copy of the newsletter.
Has anyone on the list has participated in trials of
pramipexole or ropinirole, and found that they did indeed allow
them to postpone levodopa therapy? What were your experiences
with these medications - how long they were effective, at what
dosage, any side effects, was there substantial symptomatic
improvement, do you take eldepryl as well? When I discussed these
drugs with my neuro last winter, he wasn't too optimistic about
them, in terms of delaying levodopa. I'd like to bring it up
again and see if he has changed his opinion, based on these
reports. I'd appreciate any information. Thanks.
Linda Herman
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