A CROSSOVER, CONTROLLED-STUDY COMPARING PERGOLIDE WITH BROMOCRIPTINE AS AN ADJUNCT TO LEVODOPA FOR THE TREATMENT OF PARKINSONS-DISEASE

A single-blind, crossover study was carried out to compare the efficac y and safety of pergolide against that of bromocriptine in 57 patients with Parkinson's disease who showed a declining response to levodopa therapy. Patients were randomly assigned to receive either bromocripti ne followed by pergolide, or pergolide followed by bromocriptine. Both drugs were administered for 12 weeks. Patients were assessed by a cli nician blinded to treatment assignment using the New York University P arkinson's Disease Scale. The average daily dose of pergolide was 2.3 +/- 0.8 mg and of bromocriptine 24.2 +/- 8.4 mg. Addition of pergolide or bromocriptine resulted in a significant improvement in total score s when compared with the previous treatment of levodopa alone (pergoli de, p = 0.0001; bromocriptine, p = 0.0005). Pergolide was more effecti ve than bromocriptine in daily living scores (p = 0.02) and motor scor es (p = 0.038). No differences in the incidence of dyskinesias, dyston ias, or psychosis were observed between groups. Fewer adverse events w ere recorded in the pergolide group, and most patients and physicians preferred pergolide to bromocriptine. Pergolide as adjunctive therapy to levodopa was more effective than bromocriptine in this short-term t rial.