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We treated 36 patients with motor fluctuations and dyskinesias on chronic levodopa therapy with cabergoline(CBG)once a day for a mean period of 14. 2+/-5.8 months.There was a significant increase in the"on"hours and reduction in"off-period"dystonia.Ten patients continued to show a marked improvement after 28.3 months of treatment(mean dose,11.3+/-4.5 mg).In 23 patients,increased dyskinesias(daily CBG dose,11+/-4.3 mg)had complicated the positive effect after 17.2+/-4.8 months.Three patients(daily CBG dose, 14.3 mg)were therapeutic failures,and administration of CBG was stopped. Side effects leading to CBG discontinuation were visual hallucinations(n= 5),heart failure(n=5),and nausea and vomiting(n=1).Plasma CBG levels, measured in seven patients taking 3,5,or 7 mg daily(po),showed fairly stable concentrations throughout the 24 hours.We concluded that CBG is an efficient dopamine agonist that can provide continuous dopaminergic stimulation when taken orally once a day. |
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