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Pramipexole offers new approach to treating Parkinson's disease WESTPORT, Jul 06 (Reuters) - The development and approval of pramipexole may be the beginning of a "new paradigm" for treatment of Parkinson's disease, according to Dr. Montford F. Piercey of Pharmacia and Upjohn, Inc., in Kalamazoo, Michigan. Dr. Piercey describes the pharmacology of pramipexole (Mirapex, Pharmacia and Upjohn), a nonergot dopamine agonist, in the May/June issue of Clinical Neuropharmacology. The author explains that pramipexole's preferential affinity for the dopamine D2 subfamily receptors, in particular the dopamine D3 receptor, may underlie its efficacy in the treatment of motor and psychiatric symptoms in Parkinson's disease. Its neuroprotective effect may stem from a reduction of dopamine turnover and possibly by a direct dopamine-neuron trophic effect. Several clinical studies have shown that patients with early disease "...can remain on pramipexole for long time periods without the need to add L-dopa," and that it can be used with L-dopa in late disease. With this in mind, Dr. Piercey recommends "...a new paradigm for the treatment of this debilitating disease so that patient exposures to L-dopa are minimized." Specifically, "...patients can be treated first with pramipexole monotherapy, adding minimal L-dopa dose treatment only as necessary in the later stages of disease." Such an approach, he believes, will likely be validated in clinical practice. Clin Neuropharmacol 1998;21:141-151. -Westport Newsroom 203 319 2700 -- Judith Richards, London, Ontario, Canada [log in to unmask]