ADJUNCTIVE CABERGOLINE THERAPY OF PARKINSONS-DISEASE - COMPARISON WITH PLACEBO AND ASSESSMENT OF DOSE RESPONSES AND DURATION OF EFFECT

Adjunctive cabergoline or placebo, in doses up to 5 mg daily, were adm inistered to Parkinson's disease patients with short-duration levodopa responses in a 6-month double-blind trial. The 13 patients randomized to cabergoline and completing the study had significantly improved Un ified Parkinson's Disease Rating Scale (UPDRS) motor scores and timed hand-tapping test scores. Serial measurements on test days documented improved scores: (a) before the first levodopa (and cabergoline) dose of the day, (b) at the time of the peak levodopa effect, and (c) at th e end of the levodopa response cycle, 5 h after test doses, Continued testing verified that these therapeutic responses were sustained for a t least 48 h after the last cabergoline dose, Patients randomized to p lacebo failed to improve on any of these measures. In a subsequent ope n-label dose-escalation phase, further improvement was documented as t he dosage was gradually raised to 10 mg daily. As in the double-blind phase, levodopa reduction allowed the improvement to occur in the abse nce of significantly increased dyskinesias. Other side effects were mo re substantial with higher doses, however, including two of 11 patient s with hallucinations and confusion. In summary, adjunctive single-dai ly-dose cabergoline therapy resulted in long-lasting, dose-related imp rovement in parkinsonism not seen in patients receiving placebo.