Bromocriptine

Abstract

In a double-blind trial with a placebo phase, low-dose bromocriptine therapy (average dose, 15 mg per day) produced a significant improvement in 25 idiopathic parkinsonian patients. Tremor and bradykinesia were equally and significantly improved in both the levodopa-treated and the de novo patients. Rigidity was most improved in the levodopa-treated subjects. Age was not a factor in determining the dose of bromocriptine or the degree of improvement. Adverse effects occurred in 30% but were mild and dose-dependent. Four subjects, unable to tolerate initial doses of bromocriptine, withdrew from the trial. A low initial dose (1 mg per day) and slow escalation in dosage produced an optimal, though delayed improvement. Low-dose bromocriptine therapy is effective, does not induce significant dyskinesia nor on-off phenomenon, and is probably an alternative to levodopa as a drug of first choice in Parkinson disease.

Hypotensive Effect of Long-Term Levodopa in Patients with Parkinson’s Disease

“…Levodopa with carbidopa at a dose of 100 mg produced a depressor response in our study, whereas bromocriptine at a dose of more than 30 mg daily is reportedly necessary in order to decrease blood pressure [19][20][21][22], Currently, however, a low dose of less than 30 mg of bromocriptine daily is recom mended for Parkinson's disease, since the efficacy is sub stantial and dyskinesia or on-off phenomenon is rarely observed at this dose [28,29]. Thus, levodopa combined with DCI may be a practical choice for patients with Parkinson's disease with hypertension.…”

Outpatient Treatment of Parkinson’s Disease

“…Other investigations [5,8] describe 15-40% after 2-3 years of treatment, with a higher incidence after fur ther treatment. It has been shown that the combination of bromocriptine and dopa preparations can delay the on-off effects in parkinsonism [9], but in this study the indication for starting bromocriptine mostly was on-off performance. The patients who have been treated with bromocriptine were compared with the patients who had not, and there is no difference in the progress of disease in the two groups, which has been shown in earlier inves tigations [5].…”

The Sydney Multicentre Study of Parkinson's disease: a randomised, prospective five year study comparing low dose bromocriptine with low dose levodopa-carbidopa.

“…Of these 10 patients, seven satisfied criteria for dementia. 8 Levodopa-carbidopa group The main reasons for breaking the code in the levodopa-carbidopa group were dyskinesia and dystonia (see later). Low dose levodopacarbidopa proved ineffective in eight patients who had rapidly progressive disease (mean dose 475 mg/day, range 300-600 mg/day); a further six patients experienced confusion and hallucinations and four patients on levodopacarbidopa had nausea.…”