Dopamine agonists in Parkinsons Disease
What dopamine agonists are available to treat Parkinsons Disease, and what are their most common side effects?
Until 1997, only two dopamine agonists (bromocriptine and pergolide) were clinically used in Parkinsons Disease.
Since then, pramipexole, ropinirole, apomorphine, and rotigotine have become commercially available.
Both bromocriptine and pergolide are ergot derivatives and have the risk of complications such as vasoconstriction (with acroparesthesias and angina), exacerbation of peptic ulcer disease, erythromelalgia, and valvular, pulmonary, and retroperitoneal fibrosis.
Pramipexole, ropinirole, and rotigotine are nonergoline agonists and have a lower risk of such complications.
What are the most common side effects of Dopamine agonists
Although dopamine agonists display fewer motor complications than levodopa, they may exacerbate peak-dose dyskinesias and other undesired dopaminergic effects, such as
- sudden sleep attacks,
- orthostatic hypotension,
- confusion, and
Furthermore, dopamine agonists have been linked to the dopamine dysregulation syndrome, including impulse control disorders as well as hypersexuality, pathological gambling, compulsive shopping, and other impulsive and compulsive behaviors.
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