Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper presents a review of the literature on the therapeutic action and the side effects of the two main dopaminergic agents: L-DOPA/decarboxylase inhibitor (L-DOPA/DI) and bromocriptine (Parlodel used either as monotherapy or in combination in patients with Parkinson's disease. The combination of L-DOPA/DI and bromocriptine gives the best therapeutic efficacy (49% improvement) in the total score (bradykinesia, rigidity and tremor). However, treatment by monotherapy or combination gives the same pattern of activity: greatest improvement in tremor, followed by rigidity and bradykinesia. Improvement observed in the short term is not sustained over longer periods of time for monotherapy with either drug. The short-term side effects are similar for each treatment, whereas long-term complications (dyskinesia, end-of-dose deterioration and on-off phenomenon) appear only when levodopa is used, alone (high incidence) or in combination with bromocriptine (low incidence). The overall optimum treatment is obtained with a combination of L-DOPA/DI and bromocriptine.
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PMID:Optimum symptomatic control of Parkinson's disease with dopaminergic therapy. 367 21

Bromocriptine (Parlodel) was given for 2 years to 17 parkinsonian patients showing inadequate response to treatment over a mean of 7 years with levodopa combined with a decarboxylase inhibitor. 11 of the patients had developed dyskinesia and 13 the on-off phenomenon during levodopa therapy. When the dose of bromocriptine reached 30 mg daily, after 4 weeks' treatment, a highly significant improvement (p less than 0.001) was observed in the following six variables: bradykinesia, rigidity, tremor, feeding, dressing and speech. These improvements have now been maintained for 2 years. The on-off phenomenon disappeared in 9 out of 13 patients. Side effects were mild and transient. Involuntary movements existing prior to bromocriptine administration were improved by reducing the dose of levodopa. The mean daily dose--after progressive and individual adjustment--was 46 mg bromocriptine combined with 435 mg levodopa plus decarboxylase inhibitor.
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PMID:Bromocriptine combined with levodopa in Parkinson's disease. 711 8