IMPROVEMENT OF MOTOR FLUCTUATIONS IN PATIENTS WITH PARKINSONS-DISEASEFOLLOWING TREATMENT WITH HIGH-DOSES OF PERGOLIDE AND CESSATION OF LEVODOPA

The combination of levodopa and a dopamine agonist in the treatment of patients with Parkinson's disease often reduces the severity of motor fluctuations. In patients with very severe motor fluctuations, monoth erapy with continuous subcutaneous infusions of the dopamine agonist a pomorphine may result in a marked reduction of hyperkinesia and on-off phenomena. We report 3 patients with Parkinson's disease and motor fl uctuations who received high doses of pergolide without levodopa resul ting in a reduction of motor fluctuations. All patients received doses of pergolide exceeding the maximum recommended dose. One patient also required additional therapy with amantadine. These data show that in some patients oral treatment with high doses of a dopamine agonist may improve the severity of motor fluctuations and achieve a good control of parkinsonian signs without concomitant levodopa treatment.