A trial of dextromethorphan in parkinsonian patients with motor response complications
Identifieur interne : 001F25 ( Main/Exploration ); précédent : 001F24; suivant : 001F26A trial of dextromethorphan in parkinsonian patients with motor response complications
Auteurs : Leo Verhagen Metman [États-Unis] ; Pierre J. Blanchet [États-Unis] ; Pep N Van Den Munckhof [États-Unis] ; Paolo Del Dotto [États-Unis] ; Remco Natté [États-Unis] ; Thomas N. Chase [États-Unis]Source :
- Movement Disorders [ 0885-3185 ] ; 1998-05.
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Abstract
The effects of the NMDA antagonist dextromethorphan (DM) on levodopa‐associated dyskinesias and motor fluctuations were studied in patients with advanced Parkinson's disease. During initial open‐label dose escalation, 6 of 18 patients reported a beneficial effect at their individually determined optimal DM dose (range, 60–120 mg/day). The 12 remaining patients either experinced reversible side effects, particularly mild drowsiness, or decreased levodopa efficacy, and were therefore excluded from the study. The six responders entered the double‐blind, placebo‐controlled, crossover study with two 2‐week arms separted by 1 week wash‐out. On the last day of each arm, motor ratings were performed every 20 minutes for 8 consecutive hours. In addition, motor complications and Activities of Daily Living (ADL) were assessed using the Unified Parkinson's Disease Rating Scale (UPDRS) and patient diaries. With DM, dyskinesias improved by 25% according to physician's ratings and by 40% accfording to UPDRS interviews, without compromising the anti‐Parkinson effect of levodopa. Motor fluctuations and ADL scores also improved significantly. Although the narrow therapeutic index of DM limits its clinical usefulness, these findings support the view that drugs acting to inhibit glutamatergic transmission at the NMDA receptor can ameliorate levodopa‐associated motor complications.
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DOI: 10.1002/mds.870130307
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="1998-05">1998-05</date><biblScope unit="volume">13</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="414">414</biblScope><biblScope unit="page" to="417">417</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">6678D223545AE509A9A53066038F609551C223B3</idno><idno type="DOI">10.1002/mds.870130307</idno><idno type="ArticleID">MDS870130307</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Glutamate</term><term>Motor complications</term><term>NMDA</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The effects of the NMDA antagonist dextromethorphan (DM) on levodopa‐associated dyskinesias and motor fluctuations were studied in patients with advanced Parkinson's disease. During initial open‐label dose escalation, 6 of 18 patients reported a beneficial effect at their individually determined optimal DM dose (range, 60–120 mg/day). The 12 remaining patients either experinced reversible side effects, particularly mild drowsiness, or decreased levodopa efficacy, and were therefore excluded from the study. The six responders entered the double‐blind, placebo‐controlled, crossover study with two 2‐week arms separted by 1 week wash‐out. On the last day of each arm, motor ratings were performed every 20 minutes for 8 consecutive hours. In addition, motor complications and Activities of Daily Living (ADL) were assessed using the Unified Parkinson's Disease Rating Scale (UPDRS) and patient diaries. With DM, dyskinesias improved by 25% according to physician's ratings and by 40% accfording to UPDRS interviews, without compromising the anti‐Parkinson effect of levodopa. Motor fluctuations and ADL scores also improved significantly. Although the narrow therapeutic index of DM limits its clinical usefulness, these findings support the view that drugs acting to inhibit glutamatergic transmission at the NMDA receptor can ameliorate levodopa‐associated motor complications.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Maryland</li></region></list><tree><country name="États-Unis"><region name="Maryland"><name sortKey="Metman, Leo Verhagen" sort="Metman, Leo Verhagen" uniqKey="Metman L" first="Leo Verhagen" last="Metman">Leo Verhagen Metman</name></region><name sortKey="Blanchet, Pierre J" sort="Blanchet, Pierre J" uniqKey="Blanchet P" first="Pierre J." last="Blanchet">Pierre J. Blanchet</name><name sortKey="Chase, Thomas N" sort="Chase, Thomas N" uniqKey="Chase T" first="Thomas N." last="Chase">Thomas N. Chase</name><name sortKey="Dotto, Paolo Del" sort="Dotto, Paolo Del" uniqKey="Dotto P" first="Paolo Del" last="Dotto">Paolo Del Dotto</name><name sortKey="Natte, Remco" sort="Natte, Remco" uniqKey="Natte R" first="Remco" last="Natté">Remco Natté</name><name sortKey="Van Den Munckhof, Pep N" sort="Van Den Munckhof, Pep N" uniqKey="Van Den Munckhof P" first="Pep N" last="Van Den Munckhof">Pep N Van Den Munckhof</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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