Clinical Experience with Budipine in Parkinsonian Therapy

Abstract

For about two decades, drug therapy of parkinsonism has centered around oral levodopa substitution (Barbeau 1961; Birkmayer and Hornkiewicz 1961; Gerstenbrand et al. 1963; Cotzias et al. 1967). In recent years, there has been growing awareness of the shortcomings of this form of therapy, characterized by declining clinical efficacy on the one hand and increase in central side effects on the other during long-term levodopa treatment (Fahn and Calne 1978; Gerstenbrand et al. 1978; Rinne 1981). Dopamimetic agonists may frequently serve as an alternative therapy in parkinsonian patients with complications of prolonged levodopa substitution (Calne et al. 1974, 1978; Lieberman et al. 1976), but show declining efficacy themselves (Lees and Stern 1981) and may also induce dyskinesias and paranoid symptoms. For these reasons “classical” antiparkinsonian agents like the anticholinergics and amantadine have regained importance in the treatment of early Parkinson’s disease (Fahn and Calne 1978) as well as adjuvants when levodopa dosage has to be reduced because of side effects.