End-of-dose akinesia after a single intravenous infusion of the dopaminergic agonist piribedil in Parkinson's disease patients: a pharmacokinetic/pharmacodynamic, randomized, double-blind study.

This randomized, double-blind trial was designed to define the possible relationship between piribedil plasma concentrations and the decrease of the Unified Parkinson's Disease Rating Scale (UPDRS) motor score or the switch from off to on state after single intravenous infusion. Ten fluctuating patients with idiopathic Parkinson's disease (PD) received escalating doses of piribedil (2-16 mg) and placebo. Starting from 2 mg, piribedil was effective in reducing the motor deficit (UPDRS, motor score) including akinesia at the first evaluation time point of 15 minutes, and in reversing off state of 7 of 10 patients. The doses were equally effective, although the effect was more sustained with the highest dose of 16 mg. Piribedil was well tolerated up to a 16-mg dose and pharmacokinetics were linear up to the 16-mg dose. Plasma levels of piribedil were not correlated to the motor score improvement or switch from off-->on. In conclusion, a short single infusion of piribedil at 2 to 16 mg was safe and effective in improving motor symptoms, including akinesia, of fluctuating PD patients.

Electroanalytical characteristics of piribedil and its differential pulse and square wave voltammetric determination in pharmaceuticals and human serum.

The electrochemical oxidative behavior of piribedil (PR) was described. It was investigated by cyclic, linear sweep, differential pulse (DPV) and square wave (SWV) voltammetric techniques. The redox behavior of PR was found irreversible. Different parameters were tested to optimize the conditions for the determination of PR. The dependence of intensities of currents and potential on pH, concentration, scan rate, nature of the buffer was investigated. Two sensitive methods for the measurement of PR were described. For analytical purposes, a very well resolved diffusion controlled voltammetric peak was obtained in 0.1 M H(2)SO(4) and pH 5.7 acetate buffer. The determination peaks are obtained at 1.27 and 0.95 V for differential pulse and 1.29 and 0.97 V for SWV in 0.1 M H(2)SO(4) and pH 5.7 acetate buffer, respectively. The linear response was obtained in the ranges of 2 x 10(-6)-1 x 10(-3) M in 0.1 M H(2)SO(4) and 2 x 10(-6)-8 x 10(-4) M in pH 5.7 acetate buffer for both techniques. The proposed techniques were successfully applied to the determination of PR in tablet dosage forms and human serum. Excipients did not interfere in the determination. The necessary statistical validation reveals that the proposed methods are free from significant systematic errors.

Transdermal administration of piribedil reverses MPTP-induced motor deficits in the common marmoset.

The ability of transdermal administration of the dopamine D2/D3 agonist piribedil (1-[3,4-methylenedioxybenzyl)]-4-[(2-pyrimidinyl)]piperazine) to reverse hypokinesia and other motor deficits observed in MPTP-treated common marmosets was investigated. Piribedil (2.5-10.0 mg/animal), applied directly to the skin of the abdomen as a paste, produced a long-lasting and concentration-dependent reversal of motor deficits. The antiparkinsonian actions of piribedil occurred within 10 minutes of drug administration and lasted as long as 10 hours. Transdermally applied piribedil produced a pattern of locomotor activity characteristic of normal motor behavior in this species. Symptoms of nausea (marked excessive salivation, retching, and/or vomiting) were not observed after transdermal application of piribedil. Additionally, pretreatment with the peripheral dopamine antagonist domperidone enhanced the antiparkinsonian effects of piribedil. Application to the skin of monolayer or bilayer patches impregnated with piribedil also produced a marked increase in locomotor activity and reversal of motor deficits. After application of various patch fractions (whole, one-half, or one-fourth), the increase in locomotor activity and reversal of disability correlated well with the surface area of skin covered. Measurement of serum levels of piribedil after single application of bilayer patches showed a positive relationship between drug levels and antiparkinsonian activity. Repeated daily application of piribedil bilayer patches for 5 days to MPTP-treated common marmosets primed to show dyskinesia by previous exposure to L-Dopa produced antiparkinsonian activity accompanied by dyskinetic movements. Transdermal administration of dopamine agonists such as piribedil may provide a useful means of producing a long-lasting reversal of motor deficits in Parkinson's disease while avoiding acute adverse effects such as nausea.

Solid-phase extraction of piribedil and its metabolites from plasma and urine without and after deconjugation, by high performance liquid chromatography.

A new high performance liquid chromatographic procedure has been developed for the simultaneous quantification of piribedil (PD) and its three main basic metabolites in rat plasma and urine, without and after hydrolysis. The procedure relies on isolation of the compounds from plasma and urine constituents using the Sep-Pak C18 cartridge, with satisfactory recovery and specificity, and resolution by acetonitrile gradient elution on a C18 reversed phase column coupled to a UV detector monitored at 240 nm. The assay was linear over a wide range of concentrations for all compounds in both body fluids with mean within-day and day-to-day coefficient of variation (CV) and relative error (RE) generally below 10%. Plasma concentrations of PD and its metabolites at selected intervals and urinary recoveries of all compounds before and after enzymatic hydrolysis are presented.

Determination of piribedil and its basic metabolites in plasma by high-performance liquid chromatography.

A high-performance liquid chromatographic method for the determination of piribedil and its p-hydroxylated, catechol and N-oxide metabolites in plasma is described. After addition of an internal standard (buspirone), the plasma samples were subjected to a three-step extraction procedure. The final extracts were evaporated to dryness under nitrogen, and the residues were reconstituted in 100 microliters of mobile phase (0.01 M phosphate buffer-acetonitrile, 50:50, v/v) and chromatographed by acetonitrile gradient elution on a C18 reversed-phase column coupled to an ultraviolet detector set at 240 nm. The method was selective for piribedil and its metabolites, and sufficiently sensitive and precise for studies aimed at elucidating the role of the metabolites in the parent drug's pharmacological effects.