Apomorphine: An underutilized therapy for Parkinson's disease

Parkinson's disease, visual hallucinations and apomorphine: A review of the available evidence

“…This piperidine moiety is also incorporated in the chemical structure of many antipsychotic medications, including piperidine phenothiazines, haloperidol, risperdone, bulbocapnine and other aporphines [75,76]. Based on the structural similarities, it has been argued that the antipsychotic potential of apomorphine is due to the specific action of this piperidine moiety in binding to dopaminergic and serotonergic receptors (particularly 5-HT2A-receptors), producing an antagonistic effect [9,12,[76][77][78].…”

“…Results from both animal and genetic studies suggest an inverted U-shaped relationship between D1-like receptor activity and prefrontal function (Figure 2), with both low and high dopaminergic activity impairing function of the prefrontal regions, clinically manifesting as reduced working memory and attention [76,77]. In other words, the optimal prefrontal performance is achieved with intermediate dopaminergic activity and whether stimulation or inhibition of D1-like receptors yields this optimum depends on the baseline dopaminergic activity in the prefrontal cortex.…”

Imaging apomorphine stimulation of brain arachidonic acid signaling via D2-like receptors in unanesthetized rats

“…Apomorphine has been used acutely and chronically to improve motor function in Parkinson's disease (Gancher et al 1989;Hagell and Odin 2001;Poewe and Wenning 2000). In Parkinson's disease, the quality of motor responses to apomorphine and levodopa is indistinguishable, but a more rapid onset, shorter duration of antiparkinson effects, and fewer motor fluctuations following apomorphine make it particularly useful as a treatment option (Kempster et al 1990).…”

Advances in Drug Therapy: Alternative Treatments for the Control of Motor Fluctuations and Dyskinesias

“…Apomorphine has a rapid absorption (C max 20 minutes) and a half-life of 43 minutes, which is consistent with its rapid onset of action with evident effects after 15-20 minutes of subcutaneous administration. The efficacy of intermittent subcutaneous apomorphine has been confirmed in several studies (Poewe & Wenning, 2000;Pfeiffer et al, 2007). Moreover, the effectiveness of continous subcutaneous apomorphine infusion apomorphine (CSAI) has been evaluated both in monotherapy as in addition to levodopa treatment in advanced PD.…”