Rationale for use of dopamine agonists in Parkinson's disease: Review of ergot derivatives

While dopamine agonists are still traditionally used as adjunct medications to improve performance and smooth out motor response complications in adva nced levodopa-treated Parkinson's disease, they are increasingly used in mo notherapy or early in combination with levodopa particularly in patients un der 65 years of age. Long-term studies using bromocriptine showed efficacy in lowering the cumulative levodopa dose and reducing the early incidence o f levodopa-related motor response complications. New dopamine agonists have recently shown efficacy as adjunct medications in short-term trials. While we now have more options to fit our individual patients' needs and toleran ce, it is important to view the new agonists in the light of the results ob tained with ergot derivatives. In this article, the rationale for use and e fficacy profile of the ergolines are briefly reviewed.