The non-ergot-agonist ropinirole in the treatment of Parkinson's disease

Ropinirole is the first non-ergoline receptor agonist with a high, specific affinity to the D-2 receptor family, no affinity to D-1 receptors, and onl y a slight affinity to other neurotransmitters worldwide. Ropinirole has be en approved for initial monotherapy of Parkinson's disease. The structure o f this agent from the second generation of dopamine agonists is similar to that of dopamin. Clinical studies have shown ropinirole to be highly potent in the treatment of Parkinson's disease. The efficacy of ropinirole in ear ly stages of the disease is comparable to that of L-dopa. Ropinirole shows a remarkably low tendency to cause dyskinesias. Early treatment of Parkinso n's disease with ropinirole as monotherapy delays the initiation of necessa ry L-dopa therapy, thereby reducing long-term complications associated with high-dosage L-dopa monotherapy. Combination therapy with ropinirole and L- dopa facilitates maintenance therapy with low doses of L-dopa, thereby sign ificantly reducing the L-dopa load and "off" periods as well as possible dy skinesias induced by L-dopa treatment. The currently available clinical fin dings on the treatment of Parkinson's disease allow the conclusion that neu roprotection needs to be incorporated in the therapeutic concept right from the start. The indication that ropinirole may possess neuroprotectiv prope rties, together with its favourable safety profile, make this agent an effe ctive dopamine agonist in the treatment of Parkinson's disease.