The drugs levodopa and pramipexole both appear to be reasonable options as initial therapy for Parkinson disease, but they are associated with different efficacy and adverse effects, according to an article in the July issue of The Archives of Neurology, one of the JAMA/Archives journals.
Parkinson disease is a progressive neurologic disease. It is believed to be related to low levels of the important neurotransmitter (messenger) dopamine in certain parts of the brain. When the drug levodopa is taken orally, it crosses through the “blood-brain barrier” and is converted to dopamine. Another drug, carbidopa, is added to levodopa to prevent the breakdown of levodopa before it crosses into the brain. Pramipexole is one of several drugs that mimic the role of dopamine in the brain, causing the neurons to react as they would to dopamine.
The Parkinson Study Group conducted a multicenter, parallel-group, double-blind, randomized controlled trial to compare initial treatment with pramipexole vs. levodopa in early Parkinson disease, followed by levodopa supplementation, with respect to the development of motor complications, other adverse events, and functional and quality of life outcomes. Robert G. Holloway, M.D., M.P.H., of the University of Rochester, Rochester, N.Y., and colleagues reported the results for the Parkinson Study Group.
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