Zusammenfassung
Mehr als 50% der Patienten mit einer Parkinsonkrankheit die über mehr als 5 Jahre mit einer klassischen L-Dopa-Monotherapie behandelt werden, entwickeln Wirkungsfluktuationen in Form von „wearing-off“-und „on-off“-Schwankungen (Marsden et al. 1982, Poewe et al. 1986). Während wearing-off-Fluktuationen auf eine Reihe von Maßnahmen wie VerkÜrzung der Dosierungsintervalle, Addition von MAO-B-Hemmern oder Dopaminagonisten, Gabe von L-Dopa-Retard-Präparaten oder COMT-Hemmern ansprechen (Marsden 1994, Ruotinnen und Rinne 1996, Kurth et al. 1997, Baas et al. 1997), sind komplexe Wirkungsfluktuationen schwerer zu beherrschen. Letztere betreffen mindestens 10% der fluktuierenden Parkinsonpatienten und entwickeln sich oft aus einem wearing-off-Muster (Marsden und Parkes 1977). Eine kontinuierliche parenterale Verabreichung für ein L-Dopa mittels i.v.-Dauerinfusionen kann aber auch bei solchen Patienten mit refraktären on/off-Fluktuationen zu einem deutlichen Ausgleich der Wirkungsschwankungen führen (Quinn et al. 1984).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Literatur
Baes H, Beiske AG, Ghika J, Jackson M, Oertel WH, Poewe W, Ransmayr G on behalf of the study investigators (1997) Catechol-O-meth-yltransferase inhibition with tolcapone reduces the „wearing-off“ phenomenon and levodopa requirements in fluctuating parkinsonian patients. J Neurol Neurosurg Psychiatry 63: 421–428
Bittkau S, Przuntek H (1986) Lisuride infusion pump for Parkinson’s disease. Lancet ii: 349
Chaudhuri KR, Clough C (1998) Subcutaneous apomorphine in Parkinson’s disease. Effective yet underused. BMJ 316: 641
Cotzias GC, Papavasiliou PS, Fehling C, Kaufman B, Mena I (1970) Similarities between neurological effects of L-Dopa and of apomorphine. N Engl J Med 282: 31–33
Cotzias GC, Papavasiliou PS, Tolosa ES et al. (1976) Treatment of Parkinson’s disease with apomorphines: possible role of growth hormone. N Engl J Med 294: 567–572
Colzi A, Turner K, Lees AJ (1998) Continuous subcutaneous waking-day apomorphine in the long-term treatment of levodopa-induced interdose dyskinesias in Parkinson’s disease. J Neurol Neurosurg Psychiatry 64: 573–576
Corsini GU, Del Zompo M, Gessa GL, Mangoni A (1979) Therapeutic efficacy of apomorphine combined with an extracerebral inhibitor of dopamine receptors in Parkinson’s disease. Lancet i: 954–956
Critchley PHS, Grand AS Perez F, Quinn NP, Parkes JD, Marsden CD (1988) Continuous subcutaneous lisuride infusion in Parkinson’s disease. J Neural Transm 27: 55–60
Frankel JP, Lees AJ, Kempster PA, Stern GM (1990) Subcutaneous apomorphine in the treatment of Parkinson’s disease. J Neurol Neurosurg Psychiatry 53: 96–101
Hughes AJ, Bishop S, Lees AJ, et al. (1991) Rectal apomorphine in Parkinson’s disease. Lancet 337: 118
Hughes AJ, Bishop S, Kleedorfer B et al. (1993) Subcutaneous apomorphine in Parkinson’s disease: response to chronic administration for up to 5 year. Mov Disord 6: 165–170
Kapoor R, Turjanski N, Frankel J, Kleedorfer B, Lees AJ, Stern GM (1990) Intranasal apomor-phine: a new treatment in Parkinson’s disease. J Neurol Neurosurg Psychiatry 53: 1015
Kleedorfer B, Turjanski N, Ryan R, Lees AJ, Milroy C, Stern GM (1991) Intranasal apomorphine in Parkinson’s disease. Neurology 41: 761
Kurth MC, Adler GH, Hilaire MS, Singer C, Waters C, LeWitt P, Chernik DA, Dorflinger EE, Yoo K (1997) Tolcapone improves motor function and reduces levodopa requirement in patients with Parkinson’s disease experiencing motor fluctuations: a multicenter, doubleblind, randomized, placebo-controlled trial. Tolcapone Fluctuator Study Group I. Neurology 48: 81–87
Marsden CD (1994) Parkinson’s disease. J Neurol Neurosurg Psychiatry 57: 672–681
Marsden CD, Parkes JD (1977) Success and problems of long-term levodopa therapy in Parkinson’s disease. Lancet i: 345–349
Marsden CD, Parkes JD, Quinn N (1982) Fluctuations and disability in Parkinson’s disease — clinical aspects. In: Marsden CD, Fahn S (eds) Movement disorders. Butterworth Scientific, London, pp 96–122
Matthiessen A, Wright CRA (1869) Researches into the chemical constitution of the opium bases, part 1. On the action of hydrochloric acid on morphia. Proc R Soc Lond 17: 455–460
Obeso JA, Luquin MR, Maratlnez-Lage JM (1986) Lisuride infusion pump: a device for the treatment of fluctuations in Parkinson’s disease. Lancet i: 467–470
Poewe W (1996) Apomorphine in the treatment of Parkinson’s disease. Neurol Rev Int 1: 12–15
Poewe WH, Lees AJ, Stern GM (1986) Low-dose levodopa therapy in Parkinson’s disease: a 6-year follow-up study. Neurology 36:1528–1530
Poewe W, Kleedorfer B, Wagner M et al. (1989) Side-effects of subcutaneous apomorphine in Parkinson’s disease. Lancet i: 1084–1085
Poewe W, Kleedorfer B, Wagner M, Bosch S, Schelosky L (1993) Continuous subcutaneous apomorphine infusions for fluctuating Parkinson’s disease. Long-term follow-up in 18 patients. Adv Neurol 60: 656–659
Pollak P, Champay AS, Hommel M, Perret JE, Benabid AL (1989) Subcutaneous apomorphine in Parkinson’s disease. J Neurol Neurosurg Psychiatry 52: 544
Pollak P, Champay AS, Gaio JM, Hommel M, Benabid AL, Perret J (1990) Administration souscutanÉe d’apomorphine dans les fluctuations motrices de la maladie de parkinson. Rev Neurol 146: 116–122
Quinn N, Parkes JD, Marsden CD (1984) Control of on/off phenomenon by continuous intravenous infusion of levodopa. Neurology 34: 1131–1136
Ruotinnen HM, Rinne UK (1996) Entacapone prolongs levodopa response in a one month double blind study in parkinsonian patients with levodopa related fluctuations. J Neurol Neurosurg Psychiatry 60: 36–40
Schwab RS, Amador LV, Levine JY (1951) Apomorphine in Parkinson’s disease. Trans Am Neurol Assoc 76: 273–279
Stibe CMH, Lees AJ, Kempster PA, Stern GM (1988) Subcutaneous apomorphine in parkinsonian on-off oscillations. Lancet i: 403–406
Stocchi F, Ruggiere S, Antonini A, Baronti F, Brug-Hitta G, Bellantuono P, Baravi D, Agnoli A (1988) Subcutaneous lisuride infusion in Parkinson’s disease: clinical results using different modes of administration. J Neural Transm 27: 27–34
Struppler A, v Uexküll T (1953) Untersuchungen über die Wirkungsweise des Apomorphins auf den Parkinsontremor. 2 Klin Med 152: 46–57
Vaamonde J, Luquin MR, Obeso JA (1991) Subcutaneous lisuride infusion in Parkinson’s disease; response to chronic administration in 34 patients. Brain 114: 601–614
van Laar T, Jansen ENH, Essink AWG, Neef C (1992) Intranasal apomorphine in parkinsonian on-off fluctuations. Arch Neurol 49: 482–484
van Laar T, Jansen ENH, Neef C, Danhof M, Roos RAC (1995) Pharmacokinetics and clinical efficacy of rectal apomorphine in patients with Parkinson’s disease: a study of five different suppositories. Mov Disord 10: 433–439
Weil E (1884) De L’apomorphine dans certain troubles nerveux. Lyon Med 48: 411–419
Wenning GK, Bosch S, Luginger E, Wagner M, Poewe W (1999) Effects of longterm continuous subcutaneous apomorphine infusions on motor complications in advanced Parkinson’s disease. Adv Neurol (in press)
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1999 Springer-Verlag Wien
About this chapter
Cite this chapter
Poewe, W. (1999). Parenterale Therapie mit Dopaminagonisten. In: Riederer, P., Laux, G., Pöldinger, W. (eds) Neuro-Psychopharmaka Ein Therapie-Handbuch. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6400-6_30
Download citation
DOI: https://doi.org/10.1007/978-3-7091-6400-6_30
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-7315-2
Online ISBN: 978-3-7091-6400-6
eBook Packages: Springer Book Archive