Oxidative Stress and Neuroprotection pp 17-25

Part of the Journal of Neural Transmission. Supplementa book series (NEURALTRANS, volume 71)

Changing dopamine agonist treatment in Parkinson’s disease: experiences with switching to pramipexole

  • H. Reichmann
  • P. Odin
  • H. M. Brecht
  • J. Köster
  • P. H. Kraus


1202 patients suffering from Parkinson’s disease switched from other dopamine agonists to pramipexole under open conditions either abruptly or in an overlapping, gradual manner. Mostly insufficient effectiveness motivated the switch. The investigators gave equal preference to either an abrupt or an overlapping switch to pramipexole in this observational study. There was a tendency in favour of the overlapping switch procedure in those patients who were on a relatively higher dose of a dopamine agonist before the switch. The switch was performed because the investigators expected the effect of pramipexole on tremor, motor functions and depression/anhedonia to be better compared with previous dopamine agonists. The main reasons for switching to pramipexole (anti-tremor effect, anti-depressive/anti-anhedonic effect) as given by the physicians at baseline came up to expectations.

The switch to pramipexole mostly yielded further improvements irrespective of the mode of switching.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. American Academy of Neurology, Miyasaki JM, Martin W, Suchowersky O, Weiner WJ, Lang AE (2002) Practice parameter: Initiation of treatment for Parkinson’s disease: An evidence based review. Neurology 58: 11–17PubMedCrossRefGoogle Scholar
  2. Agency for Healthcare Research and Quality (2003) Diagnosis and Treatment of Parkinson’s Disease: A Systematic Review of the Literature. Summary, Evidence Report/Technology Assessment: Number 57. AHRQ Publication Number 03-E039. Rockville, MDGoogle Scholar
  3. Bain P (1993) A combined clinical and neurophysiological approach to the study of patients with tremor. J Neurol Neurosurg Psychiatry 56: 839–844PubMedGoogle Scholar
  4. Baseman DG, O’Suilleabhain PE, Reimold SC, Laskar SR, Baseman JG, Dewey Jr RB (2004) Pergolide use in Parkinson’s disease is associated with cardiac valve regurgitation. Neurology 63: 301–304PubMedGoogle Scholar
  5. Brecht HM (2001) Dopaminagonisten im Vergleich. In: Riederer P, Laux G, Pöldinger W (eds) Neuro-Psychopharmaka 5: 226–237Google Scholar
  6. Van Camp G, Flamez A, Cosyns B, Weytjens C, Muyldermans L, van Zandijcke M, de Sutter J, Santens P, Decoodt P, Moerman Ch Schoors D (2004) Treatment of Parkinson’s disease with pergolide and relation to restrictive valvular disease. The Lancet 363: 1179–1183CrossRefGoogle Scholar
  7. Canesi M, Antonini A, Mariani CB, Tesei S, Zecchinelli AL, Barichella M, Pezzoli G (1999) An overnight switch to ropinirole therapy in patients with Parkinson’s disease. Short communication. J Neural Transm 106: 925–929PubMedCrossRefGoogle Scholar
  8. Corrigan MH, Denahan AQ, Wright CE, Ragual RJ, Evans D (2000) Comparison of pramipexole, fluoxetine, and placebo in patients with major depression. Depression Anxiety 11: 58–65CrossRefGoogle Scholar
  9. Etminan M, Sudeep G, Samii A (2003) Comparison of the risk of adverse events with pramipexole and ropinirole in patients with Parkinson’s disease. A Meta-Analysis. Drug Safety 26: 439–444PubMedCrossRefGoogle Scholar
  10. Flowers CM, Racoosin JA, Lu SL, Beitz JG (2003) The US Food and Drug Administration’s registry of patients with pergolide-associated valvular heart disease. Mayo Clin Proc 78: 730–731PubMedCrossRefGoogle Scholar
  11. German Society of Neurology (2003) Leitlinien für Diagnostik und Therapie in der Neurologie; 2. revised and enlarged edition, Thieme, Stuttgart, New YorkGoogle Scholar
  12. Gimenez-Roldan S, Esteban EM, Mateo D (2001) Switching from bromocriptine to ropinirole in patients with advanced Parkinson’s disease: open label pilot responses to three different dose-ratios. Clin Neuropharmacol 24: 346–351PubMedCrossRefGoogle Scholar
  13. Goetz CG, Blasucci L, Stebbins GT (1999) Switching dopamine agonists in advanced Parkinson’s disease: is rapid titration preferable to slow? Neurology 52: 1227–1229PubMedGoogle Scholar
  14. Grosset K, Needleman F, Macphee G, Grosset D (2004) Switching from ergot to nonergot dopamine agonists in Parkinson’s disease: A clinical series and five-drug dose conversion table. Mov Disord 19: 1370–1374PubMedCrossRefGoogle Scholar
  15. Hanna PA, Ratkos L, Ondo WG, Jankovic J (2001) Switching from pergolide to pramipexole in patients with Parkinson’s disease. J Neural Transm 108: 63–70PubMedCrossRefGoogle Scholar
  16. Horvath J, Fross RD, Kleiner-Fisman G, Lerch R, Stalder H, Liaudat S, Raskoff WJ, Flachsbart KD, Rakowski H, Pache JC, Burkhard PR, Lang AE (2004) Severe multivalvular heart disease: a new complication of the ergot derivative dopamine agonists. Mov Disord 19: 656–662PubMedCrossRefGoogle Scholar
  17. Kraus P, Hoffmann A (2006) (in preparation) Spiralometry: A new technique for a computer based evaluation of paper-pencil spiralsGoogle Scholar
  18. Lemke MR, Brecht HM, Koester J, Kraus PH, Reichmann H (2005) Anhedonia, Depression and Motor Functioning in Parkinson’s Disease during treatment with Pramipexole. J Neuropsychiatry Clin Neurosci 17: 214–220PubMedGoogle Scholar
  19. Linazasoro G (2004) Spanish Dopamine Agonists Study Group: conversion from dopamine agonists to pramipexole. An open-label trial in 227 patients with advanced Parkinson’s disease. J Neurol 251: 335–339PubMedCrossRefGoogle Scholar
  20. Marinus J, Visser M, Stiggelbout AM, Rabey JM, Martínez-Martín P, Bonuccelli U, Kraus PH, van Hilten JJ (2004) A short scale for the assessment of motor impairments and disabilities in Parkinson’s disease: the SPES/SCOPA. J Neurol Neurosurg Psychiatry 75: 388–395PubMedCrossRefGoogle Scholar
  21. Mierau J, Schneider FJ, Ensinger HA, Chio CL, Lajines ME, Huff RM (1995) Pramipexole binding and activation of cloned and expressed dopamine D2, D3 and D4 receptors. Eur J Pharmacol 290: 29–36PubMedCrossRefGoogle Scholar
  22. Müller Th, Fritze J (2003) Fibrosis associated with dopamine agonist therapy in Parkinson’s disease. Clinical Neuropharmacol 26: 109–111CrossRefGoogle Scholar
  23. Olanow CW, Watts RL, Koller WC (2001) An algorithm (decision tree) for the management of Parkinson’s disease: treatment guidelines. Neurology 56[Suppl 5]: S1–S88PubMedGoogle Scholar
  24. Pogarell O, Gasser T, Van Hilten JJ, Spieker S, Pollentier S, Meier D, Oertel WH (2002) Pramipexole in patientswith Parkinson’s disease and marked drug resistant tremor: a randomised, double blind, placebo controlled multicentre study. J Neurol Neurosurg Psychiatry 72: 713–720PubMedCrossRefGoogle Scholar
  25. Rabey JM, Bass H, Bonucelli U, Brooks D, Klotz P, Korczyn AD, Kraus P, Martinez-Martin P, Morrish P, van Sauten W, van Hilten B (1997) Evaluation of the short Parkinson’s Evaluation Scale: a new friendly scale for the evaluation of Parkinson’s disease in clinical drug trials. Clin Neuropharmacol 20: 322–337PubMedCrossRefGoogle Scholar
  26. Rascol O, Pathak A, Bagheri H, Montastruc JL (2004) New concerns about old drugs: Valvular heart disease on ergot derivative dopamine agonists as an exemplary situation of pharmacovigilance. Mov Disord 19: 611–613PubMedCrossRefGoogle Scholar
  27. Reichmann H, Brecht HM, Köster J, Kraus PH (2003) Pramipexole in routine clinical practice. CNS Drugs 17: 965–973PubMedCrossRefGoogle Scholar
  28. Reichmann H, Herting B, Miller A, Sommer U (2003) Switching and combining dopamine agonists. J Neural Transm 110: 1393–1400PubMedCrossRefGoogle Scholar
  29. Reichmann H, Sommer U, Fuchs G, Hefter H, Mark G, Muller T, Thumler R, Ulm G, Vieregge P (2000) Workshop IV: drug treatment guidelines for the long-term management of parkinson’s disease. J Neurol 247[Suppl 4]: 40–41Google Scholar
  30. Rektorova I, Rektor I, Bares M, Dostál V, Ehler E, Fanfrdiovà Z, Fiedler J, Klaiblova H, Kulisták P, Ressner P, Svátová J, Urbánek K, Velísková J (2003) Depression in Parkinson’s disease: an eight-month, randomised, open-label, national multi-centre comparative study of pramipexole and pergolide. Eur J Neurol 10: 399–406PubMedCrossRefGoogle Scholar
  31. Stewart D, Morgan E, Burn D, Grosset D, Chaudhuri KR, MacMahon D, Needleman F, Macphee G, Heywood P (2004) Dopamine agonist switching in Parkinson’s disease. Hosp Med 65: 215–219PubMedGoogle Scholar
  32. Tan EK, Ratnagopal P, Han SY, Wong MC (2003) Piribedil and bromocriptine in Parkinson’s disease: a single-blind crossover study. Acta Neurol Scand 107: 202–206PubMedCrossRefGoogle Scholar
  33. Tetrud JW, Zhang J, Gomez-Mancilla B, Greenfield JC (2000) Abrupt conversion of Parkinson’s disease patients to pramipexole from bromocriptine or pergolide: Safety, tolerance, and optimal conversion ratio. Neurology 54[Suppl 3]: 279–280Google Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • H. Reichmann
    • 1
  • P. Odin
    • 2
  • H. M. Brecht
    • 3
  • J. Köster
    • 3
  • P. H. Kraus
    • 4
  1. 1.Department of NeurologyTechnical University of DresdenDresdenGermany
  2. 2.Department of NeurologyCentral Hospital BremerhavenGermany
  3. 3.Division MedicineBoehringer Ingelheim Pharma GmbH & Co. KGGermany
  4. 4.Department of Neurology, St. Josef-HospitalRuhr-University BochumGermany

Personalised recommendations