The use of dopamine agonists in very elderly patients with Parkinson's disease
Identifieur interne : 004936 ( Main/Exploration ); précédent : 004935; suivant : 004937The use of dopamine agonists in very elderly patients with Parkinson's disease
Auteurs : Lisa M. Shulman [États-Unis] ; Alireza Minagar [États-Unis] ; Alejandro Rabinstein [États-Unis] ; William J. Weiner [États-Unis]Source :
- Movement Disorders [ 0885-3185 ] ; 2000-07.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Personne âgée.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Agonist, Agonists, Antiparkinson Agents (adverse effects), Antiparkinson Agents (therapeutic use), Antiparkinson agent, Chemotherapy, Dopamine Agonists (adverse effects), Dopamine Agonists (therapeutic use), Dopamine receptor, Elderly, Female, Humans, Male, Neurologic Examination (drug effects), Parkinson, Parkinson Disease (drug therapy), Parkinson disease, Retrospective Studies, Treatment, Treatment Outcome.
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Dopamine Agonists.
- chemical , therapeutic use : Antiparkinson Agents, Dopamine Agonists.
- drug effects : Neurologic Examination.
- drug therapy : Parkinson Disease.
- Aged, Aged, 80 and over, Female, Humans, Male, Retrospective Studies, Treatment Outcome.
Abstract
BACKGROUND: Controversy exists regarding the use of dopamine receptor agonists in elderly patients with Parkinson's disease because of concern about a high rate of intolerable side effects. METHODS: A retrospective chart review was used to examine our experience with dopamine agonist use in the very elderly by identifying patients in our Parkinson's disease database who were over the age of 80 years and who had received agonists. Sixty‐nine patients were identified who had 120 separate trials of agonist therapy. Successful treatment with the agonist was defined as maintenance of the agonist for a minimum of 6 months. RESULTS: The overall success rate among the very elderly for an agonist trial was 46%. Success rates for individual agonists were 15 of 27 (56%) bromocriptine, 18 of 34 (53%) pergolide, 17 of 43 (40%) pramipexole, and 5 of 16 (31%) ropinirole. In successful trials with bromocriptine, the mean daily dose was 12.8 mg, mean duration of treatment was 40 months, and mean age at drug initiation was 82 years; for pergolide it was 1.8 mg, 32 months, and 83 years; for pramipexole 2.7 mg, 14 months, and 83 years, and for ropinirole 10.6 mg, 11 months, and 83 years. CONCLUSION: This study demonstrated that therapeutic dosages of dopamine agonists were well tolerated by 46% of very elderly patients who received a trial of an agonist. These results indicate that dopamine receptor agonist therapeutic trials are warranted in selected very elderly patients.
Url:
DOI: 10.1002/1531-8257(200007)15:4<664::AID-MDS1010>3.0.CO;2-D
Affiliations:
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Le document en format XML
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Weiner</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurology, University of Miami School of Medicine, Miami, Florida</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>John Wiley & Sons, Inc.</publisher><pubPlace>New York</pubPlace><date type="published" when="2000-07">2000-07</date><biblScope unit="vol">15</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="664">664</biblScope><biblScope unit="page" to="668">668</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">3854D95A80132977FD80A2A7BE2F4AAA1A322592</idno><idno type="DOI">10.1002/1531-8257(200007)15:4<664::AID-MDS1010>3.0.CO;2-D</idno><idno type="ArticleID">MDS1010</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Agonist</term><term>Agonists</term><term>Antiparkinson Agents (adverse effects)</term><term>Antiparkinson Agents (therapeutic use)</term><term>Antiparkinson agent</term><term>Chemotherapy</term><term>Dopamine Agonists (adverse effects)</term><term>Dopamine Agonists (therapeutic use)</term><term>Dopamine receptor</term><term>Elderly</term><term>Female</term><term>Humans</term><term>Male</term><term>Neurologic Examination (drug effects)</term><term>Parkinson</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson disease</term><term>Retrospective Studies</term><term>Treatment</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term><term>Dopamine Agonists</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term><term>Dopamine Agonists</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Neurologic Examination</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Male</term><term>Retrospective Studies</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Agoniste</term><term>Antiparkinsonien</term><term>Chimiothérapie</term><term>Parkinson maladie</term><term>Personne âgée</term><term>Récepteur dopaminergique</term><term>Traitement</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Personne âgée</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">BACKGROUND: Controversy exists regarding the use of dopamine receptor agonists in elderly patients with Parkinson's disease because of concern about a high rate of intolerable side effects. METHODS: A retrospective chart review was used to examine our experience with dopamine agonist use in the very elderly by identifying patients in our Parkinson's disease database who were over the age of 80 years and who had received agonists. Sixty‐nine patients were identified who had 120 separate trials of agonist therapy. Successful treatment with the agonist was defined as maintenance of the agonist for a minimum of 6 months. RESULTS: The overall success rate among the very elderly for an agonist trial was 46%. Success rates for individual agonists were 15 of 27 (56%) bromocriptine, 18 of 34 (53%) pergolide, 17 of 43 (40%) pramipexole, and 5 of 16 (31%) ropinirole. In successful trials with bromocriptine, the mean daily dose was 12.8 mg, mean duration of treatment was 40 months, and mean age at drug initiation was 82 years; for pergolide it was 1.8 mg, 32 months, and 83 years; for pramipexole 2.7 mg, 14 months, and 83 years, and for ropinirole 10.6 mg, 11 months, and 83 years. CONCLUSION: This study demonstrated that therapeutic dosages of dopamine agonists were well tolerated by 46% of very elderly patients who received a trial of an agonist. These results indicate that dopamine receptor agonist therapeutic trials are warranted in selected very elderly patients.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Floride</li></region></list><tree><country name="États-Unis"><region name="Floride"><name sortKey="Shulman, Lisa M" sort="Shulman, Lisa M" uniqKey="Shulman L" first="Lisa M." last="Shulman">Lisa M. Shulman</name></region><name sortKey="Minagar, Alireza" sort="Minagar, Alireza" uniqKey="Minagar A" first="Alireza" last="Minagar">Alireza Minagar</name><name sortKey="Rabinstein, Alejandro" sort="Rabinstein, Alejandro" uniqKey="Rabinstein A" first="Alejandro" last="Rabinstein">Alejandro Rabinstein</name><name sortKey="Weiner, William J" sort="Weiner, William J" uniqKey="Weiner W" first="William J." last="Weiner">William J. Weiner</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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