ABSTRACT
OBJECTIVE: To evaluate the effects of ropinirole on selected nonmotor symptoms of Parkinson's disease (PD), including anxiety, depressive symptoms, sleep disturbances/excessive daytime sleepiness, and sexual functions. METHODS: Forty-four consecutive PD patients with or without motor complications (MC+ group and MC- group, respectively); 6-month prospective study; scales administered in the "on" motor state: Unified Parkinson's Disease Rating Scale, Hamilton Anxiety Scale (HAMA), Montgomery-Asberg Depression Rating Scale (MADRS), Parkinson's Disease Sleep Scale, Epworth Sleep Scale, International Index of Erectile Function, and Female Sexual Function Index; serum sexual hormones collected. RESULTS: The median ropinirole dose was 10 mg, and the median L-dopa dose was decreased in both groups. In addition to motor symptoms and motor complications improvement, both median HAMA and MADRS scores dropped significantly in MC+ group; patients in our MC- group had little or no anxiety and depression at the baseline visit. In men, the baseline anxiety score was negatively correlated with the serum testosterone level. We did not observe any changes in the scales assessing sleep and sexual functions. Changes in Unified Parkinson's Disease Rating Scale III scores significantly correlated with ropinirole dosage. Changes in HAMA and MADRS correlated only with changes in Parkinson's Disease Sleep Scale scores. CONCLUSION: In addition to controlling motor symptoms, ropinirole improved both anxiety and depressive symptoms in PD patients with motor fluctuations and/or dyskinesias. Changes in mood and anxiety correlated with changes in sleep scores.
Subject(s)
Indoles/therapeutic use , Parkinson Disease/drug therapy , Parkinson Disease/psychology , Aged , Anxiety/drug therapy , Anxiety/physiopathology , Anxiety/psychology , Behavioral Symptoms/drug therapy , Behavioral Symptoms/physiopathology , Behavioral Symptoms/psychology , Depression/drug therapy , Depression/physiopathology , Depression/psychology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Parkinson Disease/physiopathology , Prospective Studies , Sleep Wake Disorders/drug therapy , Sleep Wake Disorders/physiopathology , Sleep Wake Disorders/psychology , Tremor/drug therapy , Tremor/physiopathology , Tremor/psychologyABSTRACT
This multicenter study investigated the safety and efficacy of intravenous valproate in acute migraine attacks and the possible impact of prophylactic valproate pre-treatment. Thirty-six patients established on migraine prophylaxis were administered 500 mg sodium valproate intravenously against acute migraine attacks. Pain development was assessed by visual analogue scale up to a 24 hours follow up interview to detect e.g. possible relapse symptoms. A subgroup analysis examined whether prophylactic treatment with valproate affected its acute anti-migraine efficacy. A meaningful headache reduction within two hours was achieved in all 12 patients with and in 20 out of 24 patients without valproate prophylaxis. Headache-associated signs and symptoms were substantially reduced. No serious side-effects were reported. The results confirm the therapeutic value of intravenous valproate in acute migraine attacks described in literature and show a beneficial effect on all investigated efficacy parameters with a trend to even better response in patients receiving valproate prophylaxis.
