Treatment of advanced Parkinson disease with pergolide

Abstract

Pergolide mesylate, a semisynthetic ergoline and a potent, long-acting central dopamine agonist, was tested in 13 patients with advanced Parkinson disease and diurnal oscillations in performance (“wearing-off” or “on-off” phenomena or both) whose response to levodopa had diminished considerably. Among all nine patients who completed the initial clinical trial, pergolide alone (two patients) or combined with levodopa (seven patients) had a marked antiparkinsonian effect. There was a significant reduction (p < 0.05) in rigidity, bradykinesia, gait disorder, and total Parkinson disease disability score. Pergolide had a marked effect in all the patients with “wearing-off” or “on-off” phenomena or both, resulting in a significant increase (p <0.01) in the duration of the time patients were “on.” The number of hours in which patients were “on” increased from 3.8 ± 0.5 (SEM) to 11.4 ± 0.8 (SEM). The mean daily dose of pergolide was 2.4 mg (range, 2 to 5 mg). Ten months later, all nine patients are doing well. Pergolide is an effective drug in patients with advanced Parkinson disease and reduces “on-off” phenomena.