1. [Apomorphine for treatment of "off-periods" in Parkinson's disease].
- Author
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Zoldan J, Merims D, Kuritzky A, Ziv I, and Melamed E
- Subjects
- Aged, Antiparkinson Agents adverse effects, Apomorphine administration & dosage, Domperidone therapeutic use, Female, Humans, Injections, Subcutaneous, Male, Middle Aged, Nausea prevention & control, Parkinson Disease physiopathology, Vomiting prevention & control, Antiparkinson Agents therapeutic use, Apomorphine therapeutic use, Levodopa adverse effects, Parkinson Disease drug therapy
- Abstract
After 3-5 years of continuous use of 1-dopa preparations for Parkinson's disease, 25%-50% of patients develop side-effects such as the "on-off" phenomenon and involuntary movements that markedly impair function. One cause of these manifestations is evidently a disturbance in the absorption of 1-dopa. We attempted to avoid this problem by using subcutaneous injections. Apomorphine is a rapid-acting dopamine agonist which causes a return from "off" to "on" within minutes. We present the results of a trial of subcutaneous injections of apomorphine in 22 Parkinsonian patients (12 males, 10 females) with severe motor fluctuations. During 5 days prior to the apomorphine all received Motilium (domperidone, 60 mg/d) to prevent nausea and vomiting. All were hospitalized initially to determine optimal dosage and to teach them the technique of self-injection. 2 to 4 mg of apomorphine were injected 1 to 3 times daily for 2 to 12 months. In 17 patients (80%) "off" periods were reduced without significant side-effects. Apomorphine seems to be effective, tolerable treatment for shortening 1-dopa induced "off" periods.
- Published
- 1999