PMID- 19855267
OWN - NLM
STAT- MEDLINE
DCOM- 20100412
LR  - 20181201
IS  - 1537-162X (Electronic)
IS  - 0362-5664 (Linking)
VI  - 33
IP  - 1
DP  - 2010 Jan-Feb
TI  - Orally disintegrating selegiline in Parkinson patients with dopamine 
      agonist-related adverse effects.
PG  - 5-10
LID - 10.1097/WNF.0b013e3181b7926f [doi]
AB  - OBJECTIVE: To determine whether adding orally disintegrating selegiline (ODS) 
      while decreasing dopamine agonist (DA) dosages would reduce DA-related adverse 
      effects (AEs) of excessive daytime sleepiness (EDS), pedal edema, hallucinations, 
      and impulse control disorders (ICDs) without compromising efficacy in Parkinson 
      disease (PD) patients. METHODS: This was a 12-week open-label study of 60 PD 
      patients with motor fluctuations and DA-related AEs of EDS, pedal edema, 
      hallucinations, and ICDs. Orally disintegrating selegiline was initiated at 1.25 
      mg once daily, and down titration of the DA was started with a goal of a 50% 
      reduction by 1 week. At week 6, ODS was increased to 2.5 mg, and further 
      reductions of the DA were allowed if the AEs were not resolved. RESULTS: The 
      addition of ODS allowed a reduction in the mean daily dose of pramipexole from 
      2.3 to 0.5 mg and immediate-release ropinirole from 11.2 to 2.9 mg. Most subjects 
      reported a reduction or resolution of DA-related AEs; 94% with EDS (n = 50), 73% 
      with pedal edema (n = 26), 86% with hallucinations (n = 15), and 84% with ICDs (n 
      = 25). Mean activities of daily living and motor scores from the Unified 
      Parkinson's Disease Rating Scale as well as quality-of-life scores were 
      significantly improved without an increase in daily "off" time. The most common 
      AEs, most of which resolved after titration, were worsening of PD, 
      nausea/vomiting, dyskinesia, increased off time, body aches, insomnia, 
      orthostatic hypotension, and increased anxiety and depression. CONCLUSIONS: In 
      most subjects, the addition of ODS with decreasing dosages of DAs substantially 
      reduced EDS, pedal edema, hallucinations, and ICDs without compromising efficacy.
FAU - Lyons, Kelly E
AU  - Lyons KE
AD  - University of Kansas Medical Center, Kansas City, KS 66160, USA. 
      lyons.kelly@att.net
FAU - Friedman, Joseph H
AU  - Friedman JH
FAU - Hermanowicz, Neal
AU  - Hermanowicz N
FAU - Isaacson, Stuart H
AU  - Isaacson SH
FAU - Hauser, Robert A
AU  - Hauser RA
FAU - Hersh, Bonnie P
AU  - Hersh BP
FAU - Silver, Dee E
AU  - Silver DE
FAU - Tetrud, James W
AU  - Tetrud JW
FAU - Elmer, Lawrence W
AU  - Elmer LW
FAU - Parashos, Sotirios A
AU  - Parashos SA
FAU - Struck, Lynn K
AU  - Struck LK
FAU - Lew, Mark F
AU  - Lew MF
FAU - Pahwa, Rajesh
AU  - Pahwa R
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Clin Neuropharmacol
JT  - Clinical neuropharmacology
JID - 7607910
RN  - 0 (Benzothiazoles)
RN  - 0 (Dopamine Agonists)
RN  - 0 (Indoles)
RN  - 0 (Monoamine Oxidase Inhibitors)
RN  - 030PYR8953 (ropinirole)
RN  - 2K1V7GP655 (Selegiline)
RN  - 83619PEU5T (Pramipexole)
SB  - IM
MH  - Administration, Oral
MH  - Aged
MH  - Benzothiazoles/adverse effects/therapeutic use
MH  - Disruptive, Impulse Control, and Conduct Disorders/chemically induced/prevention 
      & control
MH  - Dopamine Agonists/*adverse effects/*therapeutic use
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Drug Delivery Systems/methods
MH  - Female
MH  - Follow-Up Studies
MH  - Foot Diseases/chemically induced/prevention & control
MH  - Hallucinations/chemically induced/prevention & control
MH  - Humans
MH  - Indoles/adverse effects/therapeutic use
MH  - Male
MH  - Mental Status Schedule
MH  - Middle Aged
MH  - Monoamine Oxidase Inhibitors/*administration & dosage
MH  - Parkinson Disease/*drug therapy/physiopathology
MH  - Pramipexole
MH  - Quality of Life
MH  - Selegiline/*administration & dosage
MH  - Severity of Illness Index
MH  - Sleep Wake Disorders/chemically induced/prevention & control
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
EDAT- 2009/10/27 06:00
MHDA- 2010/04/13 06:00
CRDT- 2009/10/27 06:00
PHST- 2009/10/27 06:00 [entrez]
PHST- 2009/10/27 06:00 [pubmed]
PHST- 2010/04/13 06:00 [medline]
AID - 10.1097/WNF.0b013e3181b7926f [doi]
PST - ppublish
SO  - Clin Neuropharmacol. 2010 Jan-Feb;33(1):5-10. doi: 10.1097/WNF.0b013e3181b7926f.