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首页> 外文期刊>Clinical neuropharmacology >Orally disintegrating selegiline in Parkinson patients with dopamine agonist-related adverse effects.
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Orally disintegrating selegiline in Parkinson patients with dopamine agonist-related adverse effects.

机译：帕金森病患者的口腔崩解司来吉兰有多巴胺激动剂相关的不良反应。

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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.
机译：目的：确定在减少多巴胺激动剂（DA）剂量的同时添加口服崩解性司来吉兰（ODS）是否可以减少与DA有关的过度白天嗜睡（EDS），踏板浮肿，幻觉和冲动控制障碍（ICD）的不良反应（AE）。不会损害帕金森病（PD）患者的疗效。方法：这是一项为期12周的开放标签研究，研究对象为60名PD患者，这些患者具有运动波动和与DA相关的EDS，踏板水肿，幻觉和ICD AE。每天一次以1.25 mg开始口服司来吉兰的崩解，并开始向下滴定DA，目标是在1周内降低50％。在第6周，ODS增至2.5 mg，如果不良事件未解决，则允许进一步降低DA。结果：添加ODS可使普拉克索的日平均剂量从2.3 mg降低至0.5 mg，而速释罗匹尼罗从11.2 mg降低至2.9 mg。大多数受试者报告DA相关的不良事件减少或消退; EDS患者为94％（n = 50），踏板水肿患者为73％（n = 26），幻觉患者为86％（n = 15），ICD患者为84％（n = 25）。帕金森病综合评分量表中的日常生活和运动活动的平均得分以及生活质量得分得到了显着改善，而每天的“休假”时间却没有增加。最常见的AE，多数在滴定后消失，包括PD恶化，恶心/呕吐，运动障碍，休假时间增加，身体酸痛，失眠，体位性低血压以及焦虑和抑郁增加。结论：在大多数受试者中，添加具有减少DA剂量的ODS可以显着降低EDS，踏板水肿，幻觉和ICD，而不会影响疗效。

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