Time course of loss of clinical benefit following withdrawal of levodopa/carbidopa and bromocriptine in early Parkinson' s disease.
Identifieur interne : 003F79 ( PubMed/Corpus ); précédent : 003F78; suivant : 003F80Time course of loss of clinical benefit following withdrawal of levodopa/carbidopa and bromocriptine in early Parkinson' s disease.
Auteurs : R A Hauser ; W C Koller ; J P Hubble ; T. Malapira ; K. Busenbark ; C W OlanowSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2000.
English descriptors
- KwdEn :
- Aged, Antiparkinson Agents (adverse effects), Antiparkinson Agents (therapeutic use), Bromocriptine (adverse effects), Bromocriptine (therapeutic use), Carbidopa (adverse effects), Carbidopa (therapeutic use), Disability Evaluation, Disease Progression, Double-Blind Method, Female, Humans, Levodopa (adverse effects), Levodopa (therapeutic use), Male, Middle Aged, Neurologic Examination (drug effects), Parkinson Disease (diagnosis), Parkinson Disease (drug therapy), Prospective Studies, Selegiline (adverse effects), Selegiline (therapeutic use), Substance Withdrawal Syndrome (diagnosis).
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Bromocriptine, Carbidopa, Levodopa, Selegiline.
- chemical , therapeutic use : Antiparkinson Agents, Bromocriptine, Carbidopa, Levodopa, Selegiline.
- diagnosis : Parkinson Disease, Substance Withdrawal Syndrome.
- drug effects : Neurologic Examination.
- drug therapy : Parkinson Disease.
- Aged, Disability Evaluation, Disease Progression, Double-Blind Method, Female, Humans, Male, Middle Aged, Prospective Studies.
Abstract
Putative neuroprotective agents for Parkinson's disease can be assessed in untreated patients using progression of clinical disability as an index of disease progression. To avoid the confound associated with symptomatic therapy, progression of the underlying disease can be assessed by evaluating the progression of clinical disability from an untreated baseline to a final visit following wash-out of symptomatic medication. In this type of analysis it is critical to use a washout of sufficient duration to ensure elimination of symptomatic effects. To assess the time course of resolution of symptomatic effects, we evaluated 31 patients at days 1, 8, and 15 following discontinuation of levodopa/carbidopa and bromocriptine. Mean total Unified Parkinson's Disease Rating Scale scores (+/- standard error) increased (worsened) by 7.4+/-1.5 from day 1 to day 15 (p <0.0001), 4.5+/-1.2 from day 1 to day 8 (p = 0.0009), and 2.9+/-1.0 from day 8 to day 15 (p = 0.01). We conclude that a wash-out of at least 2 weeks is required to eliminate the symptomatic effects of levodopa/carbidopa and bromocriptine in patients with early Parkinson's disease.
PubMed: 10830413
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Busenbark</name></author><author><name sortKey="Olanow, C W" sort="Olanow, C W" uniqKey="Olanow C" first="C W" last="Olanow">C W Olanow</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2000">2000</date><idno type="RBID">pubmed:10830413</idno><idno type="pmid">10830413</idno><idno type="wicri:Area/PubMed/Corpus">003F79</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Time course of loss of clinical benefit following withdrawal of levodopa/carbidopa and bromocriptine in early Parkinson' s disease.</title><author><name sortKey="Hauser, R A" sort="Hauser, R A" uniqKey="Hauser R" first="R A" last="Hauser">R A Hauser</name><affiliation><nlm:affiliation>Parkinson's Disease and Movement Disorders Center, University of South Florida, Tampa 33606, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Koller, W C" sort="Koller, W C" uniqKey="Koller W" first="W C" last="Koller">W C Koller</name></author><author><name sortKey="Hubble, J P" sort="Hubble, J P" uniqKey="Hubble J" first="J P" last="Hubble">J P Hubble</name></author><author><name sortKey="Malapira, T" sort="Malapira, T" uniqKey="Malapira T" first="T" last="Malapira">T. Malapira</name></author><author><name sortKey="Busenbark, K" sort="Busenbark, K" uniqKey="Busenbark K" first="K" last="Busenbark">K. Busenbark</name></author><author><name sortKey="Olanow, C W" sort="Olanow, C W" uniqKey="Olanow C" first="C W" last="Olanow">C W Olanow</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="2000" type="published">2000</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Antiparkinson Agents (adverse effects)</term><term>Antiparkinson Agents (therapeutic use)</term><term>Bromocriptine (adverse effects)</term><term>Bromocriptine (therapeutic use)</term><term>Carbidopa (adverse effects)</term><term>Carbidopa (therapeutic use)</term><term>Disability Evaluation</term><term>Disease Progression</term><term>Double-Blind Method</term><term>Female</term><term>Humans</term><term>Levodopa (adverse effects)</term><term>Levodopa (therapeutic use)</term><term>Male</term><term>Middle Aged</term><term>Neurologic Examination (drug effects)</term><term>Parkinson Disease (diagnosis)</term><term>Parkinson Disease (drug therapy)</term><term>Prospective Studies</term><term>Selegiline (adverse effects)</term><term>Selegiline (therapeutic use)</term><term>Substance Withdrawal Syndrome (diagnosis)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term><term>Bromocriptine</term><term>Carbidopa</term><term>Levodopa</term><term>Selegiline</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term><term>Bromocriptine</term><term>Carbidopa</term><term>Levodopa</term><term>Selegiline</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Parkinson Disease</term><term>Substance Withdrawal Syndrome</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>Disability Evaluation</term><term>Disease Progression</term><term>Double-Blind Method</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Putative neuroprotective agents for Parkinson's disease can be assessed in untreated patients using progression of clinical disability as an index of disease progression. To avoid the confound associated with symptomatic therapy, progression of the underlying disease can be assessed by evaluating the progression of clinical disability from an untreated baseline to a final visit following wash-out of symptomatic medication. In this type of analysis it is critical to use a washout of sufficient duration to ensure elimination of symptomatic effects. To assess the time course of resolution of symptomatic effects, we evaluated 31 patients at days 1, 8, and 15 following discontinuation of levodopa/carbidopa and bromocriptine. Mean total Unified Parkinson's Disease Rating Scale scores (+/- standard error) increased (worsened) by 7.4+/-1.5 from day 1 to day 15 (p <0.0001), 4.5+/-1.2 from day 1 to day 8 (p = 0.0009), and 2.9+/-1.0 from day 8 to day 15 (p = 0.01). We conclude that a wash-out of at least 2 weeks is required to eliminate the symptomatic effects of levodopa/carbidopa and bromocriptine in patients with early Parkinson's disease.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">10830413</PMID><DateCreated><Year>2000</Year><Month>10</Month><Day>02</Day></DateCreated><DateCompleted><Year>2000</Year><Month>10</Month><Day>02</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0885-3185</ISSN><JournalIssue CitedMedium="Print"><Volume>15</Volume><Issue>3</Issue><PubDate><Year>2000</Year><Month>May</Month></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Time course of loss of clinical benefit following withdrawal of levodopa/carbidopa and bromocriptine in early Parkinson' s disease.</ArticleTitle><Pagination><MedlinePgn>485-9</MedlinePgn></Pagination><Abstract><AbstractText>Putative neuroprotective agents for Parkinson's disease can be assessed in untreated patients using progression of clinical disability as an index of disease progression. To avoid the confound associated with symptomatic therapy, progression of the underlying disease can be assessed by evaluating the progression of clinical disability from an untreated baseline to a final visit following wash-out of symptomatic medication. In this type of analysis it is critical to use a washout of sufficient duration to ensure elimination of symptomatic effects. To assess the time course of resolution of symptomatic effects, we evaluated 31 patients at days 1, 8, and 15 following discontinuation of levodopa/carbidopa and bromocriptine. Mean total Unified Parkinson's Disease Rating Scale scores (+/- standard error) increased (worsened) by 7.4+/-1.5 from day 1 to day 15 (p <0.0001), 4.5+/-1.2 from day 1 to day 8 (p = 0.0009), and 2.9+/-1.0 from day 8 to day 15 (p = 0.01). We conclude that a wash-out of at least 2 weeks is required to eliminate the symptomatic effects of levodopa/carbidopa and bromocriptine in patients with early Parkinson's disease.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Hauser</LastName><ForeName>R A</ForeName><Initials>RA</Initials><AffiliationInfo><Affiliation>Parkinson's Disease and Movement Disorders Center, University of South Florida, Tampa 33606, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Koller</LastName><ForeName>W C</ForeName><Initials>WC</Initials></Author><Author ValidYN="Y"><LastName>Hubble</LastName><ForeName>J P</ForeName><Initials>JP</Initials></Author><Author ValidYN="Y"><LastName>Malapira</LastName><ForeName>T</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Busenbark</LastName><ForeName>K</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Olanow</LastName><ForeName>C 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