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A combined regimen of subcutaneous lisuride and oral Madopar HBS in Parkinson’s disease

  • C. Chouza
  • J. L. Caamaño
  • Ofrenda de Medina
  • Ruth Aljanati
  • A. Scaramelli
  • Susana Romero
Conference paper
Part of the Journal of Neural Transmission book series (NEURAL SUPPL, volume 27)

Summary

At the first stage of a pilot study involving 14 parkinsonians with motor fluctuations, treatment with standard Madopar was substituted by a sustained-release form, Madopar HBS, which attenuated fluctuations in patients with end-of-dose impairment, but achieved only moderate improvement in patients with on-off phenomena.

In a second phase of the trial, 4 parkinsonians exhibiting the most severe fluctuations of mobility and the poorest response to Madopar HBS (Hydrodynamically Balanced System) were selected for treatment with a combined regimen utilizing subcutaneous lisuride infusions as the additional component. The sequence of the trial was as follows:
  1. 1.

    standard Madopar,

     
  2. 2.

    Madopar HBS,

     
  3. 3.

    standard Madopar combined with lisuride infusions and

     
  4. 4.

    Madopar HBS combined with lisuride infusions.

     
Steady improvement was observed along the lines of this schedule, but the best results were obtained when Madopar HBS was combined with lisuride infusions. Subsequently motor fluctuations were less marked or disappeared, early-morning Parkinson symptoms decreased and dystonia was not recorded any longer. Even better results could be accomplished in an extended trial attempting to establish the best dosage ratio of the combination, possibly admitting increased dosage.

The tolerance of the combined regimen was excellent, except in one patient who transiently exhibited delusions and postural hypotension. The combination of sustained-release Madopar and continuous infusions of the dopaminergic agonist lisuride seems to prove a more physiological and effective regimen for the treatment of severe motor fluctuations.

Keywords

Postural Hypotension Motor Fluctuation Subcutaneous Infusion Combine Regimen Good Therapeutic Result 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

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Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • C. Chouza
    • 1
  • J. L. Caamaño
    • 1
  • Ofrenda de Medina
    • 1
  • Ruth Aljanati
    • 1
  • A. Scaramelli
    • 1
  • Susana Romero
    • 2
  1. 1.Section of Extrapyramidal DiseasesInstitute of NeurologyMontevideoUruguay
  2. 2.Instituto de Neurología Hospital de ClínicasMontevideoUruguay

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