ABSTRACT
Levodopa remains a 'gold standard' for the treatment of patients with Parkinson's disease (PD), but its chronic use is accompanied by fluctuations of symptoms and dyskinesias related to unfavorable pharmacokinetics of levodopa and progressing loss of the nigrostriatal neurons. Prescribing inhibitors of catechol-O-methyl-transferase (enzyme of dopamine metabolism), entacapone or tolcapone, is a perspective approach to the correction of the above-mentioned complications. We followed up 402 patients with PD who received long-term therapy with a combined preparation Stalevo (levodopa/carbidopa/entacapone) for 2-5 years (2.9 ± 0.9 years). The high (92.8%) compliancy and good tolerance of the drug in patients with PD was shown. Stalevo leads to the stabilization of the response to levodopa, improvement of patients' functional capacities, increase in their everyday activity, and improvement of quality of life. Stalevo may be regarded as a preparation of choice in the treatment of motor complications in elderly patients, correction of night symptoms of PD and in a number of other clinical situations arising in hospital and outpatient practice.
Subject(s)
Carbidopa/administration & dosage , Catechols/administration & dosage , Dopamine Agonists/administration & dosage , Levodopa/administration & dosage , Parkinson Disease/drug therapy , Adult , Aged , Aged, 80 and over , Carbidopa/adverse effects , Catechols/adverse effects , Dopamine Agonists/adverse effects , Drug Administration Schedule , Drug Combinations , Female , Humans , Levodopa/adverse effects , Male , Middle Aged , Parkinson Disease/physiopathology , Treatment OutcomeABSTRACT
The results of mirapex (pramipexol) treatment of 402 patients with Parkinson's disease and juvenile parkinsonism during the period from 6 months to 7 years are summarized. Mirapex was used in monotherapy as well as in combination with levadopa and other antiparkinsonic drugs. The drug was well tolerated and effective in rest tremor, hypokinesia, muscle rigidity and depression, the more pronounced effect being seen at the early stage of the disease. The use of mirapex allows an effective control of motor fluctuations developing during long-term continuous levodopa therapy. The results obtained characterize mirapex as a drug of choice in the treatment of juvenile parkinsonism. In case of a break in mirapex treatment, the recommencement of treatment usually is not accompanied by reduced sensitivity to drug effect.
Subject(s)
Antiparkinson Agents/therapeutic use , Benzothiazoles/therapeutic use , Parkinson Disease/drug therapy , Adult , Aged , Aged, 80 and over , Antiparkinson Agents/administration & dosage , Benzothiazoles/administration & dosage , Dose-Response Relationship, Drug , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pramipexole , Receptors, Dopamine D1/antagonists & inhibitors , Time Factors , Treatment OutcomeABSTRACT
Clinical and genetic analysis of juvenile parkinsonism was performed in 26 sibs from 20 families. Heterogeneity of the disorder was observed. Mutations in the parkin gene (locus PARK2, chromosome 6q25.2-27), with the prevalence of deletions over point mutations, have been identified in 41%. The comparative clinical analyses of patients examined confirmed the phenotypical polymorphism of "parkinopathy". We also showed the absence of asymmetric manifestation--an important and underestimated so far sign of the disease. The results of the study may be considered as a valuable clue to the clinical diagnosis of parkin-related juvenile parkinsonism in Russian population and implemented for mutation screening and medico-genetic counseling of affected families.
