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Long-term efficacy of bromocriptine in Parkinson disease

Department of Neurology (Drs. Lieberman, Kupersmith, Neophytides, Casson, Durso, Foo, and Khayali), the Department of Psychiatry, Neurochemistry Laboratories tDr. Goldstein), and the Department of Internal Medicine tDr. Rear), New York University School of Medicine, New York, NY.

Twenty-eight patients with Parkinson disease (PD) were treated with bromocriptine for at least 2 years (mean, 2.8 years; range, 2 to 5 years). All of them had first been treated with levodopa (alone or combined with carbidopa, as Sinemet) for 7.4 years (range, 1 to 10 years). At the time bromocriptine was started, all were showing increasing disability. In these patients, attempts to increase levodopa resulted in adverse effects, and attempts to decrease levodopa resulted in increased parkinsonism. Bromocriptine (mean daily dose, 56 mg) was added to levodopa and resulted in improvement of at least one stage (Hoehn and Yahr scale) in 21 of the patients. After 2 years, five of these patients continue to maintain this improvement. The remaining patients, although there has been deterioration, maintain some of their original improvement. Bromocriptine, when added to levodopa, results in improvement that is maintained, in part, for at least 2 years. The ratio of bromocriptine to levodopa has to be periodically readjusted.

Address correspondence and reprint requests to Dr. Lieberman, Associate Professor, Neurology, N.Y.U. Medical Center, 550 First Avenue, New York, NY 10016.

This paper was presented in part at the thirty-first annual meeting of the American Academy of Neurology. Chicago, IL, April 1979.

Accepted for publication August 14, 1979.

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