Pramipexole Reduces the Prevalence of Fatigue in Patients with Parkinson's Disease

ArticleinInternal Medicine 50(19):2163-8 · January 2011with11 Reads
DOI: 10.2169/internalmedicine.50.5456 · Source: PubMed
The aim of this multicenter cross-sectional study was to assess the relation between fatigue in a large number of Japanese patients with Parkinson's disease (PD) and drugs taken to treat PD. We used the 16-item Parkinson Fatigue Scale (PFS-16), which was designed to assess fatigue exclusively associated with PD. Multiple logistic regression analyses were used to assess the relation between antiparkinson drugs and fatigue in PD. A total of 350 non-demented PD patients were enrolled. Fatigue (PFS score of ≥4) was revealed in 319 patients (91%). Pramipexole was administered to 24% of PD patients. Multiple logistic regression analysis revealed that the administration of Pramipexole was significantly related to low rates of fatigue in PD patients with Hoehn and Yahr stage <3 (p=0.011, odds ratio=5.23, 95% confidence interval; 1.47-18.63). The reduced fatigue in PD patients was observed in taking Pramipexole.
  • [Show abstract] [Hide abstract] ABSTRACT: Parkinson's disease (PD) is a neurodegenerative disorder characterized by the progressive loss of dopaminergic neurons of substantia nigra in brain basal ganglia; accompanied by signs and symptoms of bradicinesia, muscle rigidity, resting tremor and equilibrium impairement. The cause of the disease remains unknown; however the role of genetic and environmental factors has been considered. The treatment of PD includes dopamine replacement by L-dopa administration and recently with dopamine receptor agonists as pramipexol, which is under clinical use. Pramipexol is a potent dopamine D2 receptor agonist also having high affinity for dopamine D3 receptors; this molecule is well absorbed by the oral route and its bioavailability is higher than 90%; it is minimally metabolized and unaltered excreted in urine. Pramipexol presinapticaly bound to dopaminergic reurons, inhibit dopamine release; however, when dopaminergic neurons are lesioned, as it happens in PD, pramipexol acts as a potent postsynaptic D2 agonist; demonstrating efficacy and safety as a single treatment, or when combined to L-dopa in patients with early or advanced PD. When used alone, pramipexol prolongs the time required to administer L-dopa and reduce the adverse events related to chronic L-dopa treatment. On the other hand, pramipexol reduce the fatigue symptoms observed in the early stages of PD. Pramipexol is effective in experimental depression and even better than sertraline in PD depressed patients. Studies in experimental models and in humans reveal that pramipexol has neuroprotective properties, probably by regenerating dopaminergic neurons, through inhibition of α-sinuclein oligomerization and by its antioxidant properties.
    Article · Jan 2012
  • [Show abstract] [Hide abstract] ABSTRACT: Fatigue is a common, under recognized, and poorly understood nonmotor symptom in Parkinson's disease (PD). Fatigue frequently presents early in PD, and its prevalence increases with disease progression, affecting up to 60% of patients. Fatigue has a negative impact on quality of life. Fatigue is often associated with other nonmotor symptoms, including sleep disturbance, excessive daytime sleepiness, and depression. Only a few reports have been published on the treatment of fatigue in PD (methylphenidate, levodopa, and pramipexole). Further well-designed studies, including physiotherapy, are necessary to develop more effective treatments for PD-associated fatigue. A number of patients with PD lose weight because of loss of fat. However, the evolution and determinants of weight loss are not well established. Possible determinants of weight loss in PD include loss of appetite, impaired hand-mouth coordination, difficulty in chewing and dysphagia, nausea, intestinal hypomotility, and increased energy requirements because of muscular rigidity and involuntary movements. Noticeable weight gain has repeatedly been reported after subthalamic or pallidal deep brain stimulation. Because low body weight is associated with negative health effects and a poor prognosis, monitoring weight and nutritional status should be part of PD management.
    Article · Apr 2012
  • [Show abstract] [Hide abstract] ABSTRACT: Parkinson's disease (PD) is a progressive neurodegenerative disease, involving the dopaminergic, noradrenergic, serotonergic and cholinergic systems. In addition to its cardinal motor symptoms, PD is associated with a diverse range of non-motor symptoms (NMS) that may be more important than motor symptoms. Although there is evidence for a dopaminergic contribution for several NMS in PD, NMS have been underrecognized and undertreated by clinicians. There is evidence that dopaminergic therapy, including dopamine agonists, may alleviate some NMS, such as anxiety and depression. This review focuses on published data on the effects of the non-ergoline dopaminergic agonist rotigotine transdermal system in the treatment of NMS in patients with PD. Data on the effects of orally administered non-ergoline agonists, including ropinirole and pramipexole, on NMS are also summarized.
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