Therapeutic experience with the new dopamine agonist CU 32-085 in advanced Parkinson's disease.

Twenty patients with advanced progressing Parkinson's disease have been treated with the 8-alpha-ergoline CU 32-085 in combination therapy for 3 months. With a mean daily dose of 12.65 mg, CU 32-085 together with levodopa plus a decarboxylase inhibitor produced a significant reduction in akinesia, rigor and tremor. Adverse reactions were rare and mild; in one case the drug was discontinued because of dyskinetic movements. Many of the pre-existing side effects were reduced or eliminated, particularly the involuntary movements and the levodopa response swings. The compound was considered useful in the treatment of advanced, progressing Parkinson's disease.

[Dopamine-receptor stimulators and neuroleptic-induced dyskinesia (author's transl)]. / Behandlung von neuroleptischen Späthyperkinesien mit Antiparkinsonika (Ergebnisse einer Vergleichsprüfung mit Bromocriptin, Levodopa und Trihexyphenydil).

We have examined bromocriptine, levodopa and trihexyphenydil ins ingle-blind design in 16 chronic productive schizophrenics having the same degree of tardive dyskinesias. Treatment time for each patient was 60 days: Bromocriptine was given in mean daily doses of 32 mg, levodopa 3,2 g and trihexyphenydil 27 mg. Bromocriptine and trihexyphenydil allowed the continued use of neuroleptics, without necessitating an increase in dosage. On the other hand, with levodopa 25% of the patients deteriorated, and this could not be prevented by increasing the dose of neuroleptics. Bromocriptine and trihexyphenydil permitted treatment of tardive dyskinesias, whereby bromocriptione was clinically (and statistically) superior to trihexyphenydil. Trihexyphenydil had only a slight effect on tremor, whilst treatment with levodopa was ineffective.

[Effect of high single doses of bromocriptine in schizophrenic patients with elevated serum prolactin levels and extrapyramidal side effects associated with neuroleptic treatment (author's transl)]. / Applikation von Vromocriptin in hohen Einzeldosen bei schizophrenen Patienten mit erhöhten Prolaktinwerten und neuroleptisch bedingten extrapyramidalen Störungen.

The purpose of the present study was to investigate the effect of bromocriptine in single doses of 20 and 30 mg on the unwanted effects most frequently caused by neuroleptics: elevated prolactin levels and extrapyramidal disturbances. 111 chronic schizophrenics were included in the investigations, 58 of them being treated with haloperidol and 53 with chlorpromazine. It was found that a single dose of 30 mg bromocriptine brought about a statistically significant decrease in the prolactin levels of patients treated with haloperidol but produced no more than a downward tendency in patients receiving chlorpromazine (the initial prolactin levels of both groups of patients were equal.) The effect of bromocriptine on EPS disturbances was more marked in the chlorpromazine group, but side effects such as nausea and agitation also occurred more frequently in this group. These results show that there is no correlation between the reduction in prolactin levels produced by bromocriptine and an improvement in unwanted EPS effects. This supports the hypothesis that the effect of neuroleptics on the prolactin secreting cells of the anterior pituitary and their effect on the EPS are mediated by different sets of receptors.