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Medication Improves Traditional ParkinsonÃs Therapy
ST. PAUL, MN (October 20, 1998) ñ The drug ropinirole improves symptoms for ParkinsonÃs patients experiencing stiff, slow or jerky movements, according to a study published in the October issue of Neurology, the scientific journal of the American Academy of Neurology.
Researchers studied 109 ParkinsonÃs patients over six months. Throughout the study patients used levodopa therapy; in addition, 74 patients were given ropinirole and 35 were given a placebo.
"Substituting ropinirole and reducing levodopa gives patients relief from ParkinsonÃs symptoms, plus reduces some side effects of levodopa," said neurologist and study author Abraham Lieberman, MD, national medical director of the National ParkinsonÃs Foundation in Miami, FL. "Thirty-five percent of patients taking ropinirole reduced their dose of levodopa by 20 percent, this in turn decreased stiffness, slowness and jerkiness of muscles by 20 percent."
Additionally, patients on ropinirole and levodopa improved their scores on a ParkinsonÃs rating scale measuring rigidity and movement.
ParkinsonÃs disease causes the brain to lose dopamine, which results in stiffness and rigidity of the muscles, slowness in movement and tremor of the arms and legs. Levodopa, the main treatment for the disease, is metabolized in the brain as dopamine. The brainÃs ability to metabolize and store levodopa diminishes after time and it becomes more dependent on the external supply of levodopa. Eventually most patients experience fluctuations when the medication is working and when it is not working in the body.
Ropinirole is one of a number of direct dopamine receptor agonists. These drugs mimic the actions of dopamine in the brain and thereby reduce the symptoms of ParkinsonÃs disease. Dopamine receptor agonists have been used in ParkinsonÃs treatment to complement the action of levodopa and to provide a longer duration of symptom control. Intensive research has focused on developing more effective means of replacing lost dopamine in ParkinsonÃs disease. This research has produced a number of new medications that are available to neurologists.
"Because so many patients benefit from supplementing a portion of levodopa with ropinirole, more physicians should consider prescribing both medications," said Lieberman. "In the future, patients taking ropinirole and levodopa may experience beneficial effects longer than those taking levodopa alone."
Introducing ropinirole into the existing levodopa therapy caused 43 percent of patients with dyskinesia (jerky or fragmented involuntary muscle movements) to develop a side effect of new or worse dyskinesia. When researchers reduced a patientÃs original dose of levodopa, this side effect was reduced or eliminated.
The U.S. Food and Drug Administration has approved ropinirole as both an initial therapy and an additive treatment with levodopa for ParkinsonÃs disease.
Ropinirole can be used on its own in the early stages of ParkinsonÃs disease to help reduce some ParkinsonÃs symptoms and improve difficulties in movement.
ParkinsonÃs disease is a slowly progressive, neurodegenerative disease that affects more than 1,000,000 people in the United States.
Research was supported by SmithKline Beecham Pharmaceuticals, manufacturer of ropinirole, also known as Requipô.
Improving patient care through education and research is the goal of the American Academy of Neurology, an association of more than 15,000 neurologists and neuroscience professionals. For more information about the American Academy of Neurology, visit the Web site at www.aan.com.
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