Subcutaneous apomorphine in the treatment of Parkinson's disease.

@article{Frankel1990SubcutaneousAI,
  title={Subcutaneous apomorphine in the treatment of Parkinson's disease.},
  author={J. P. Frankel and Andrew John Lees and P. A. Kempster and Gerald M. Stern},
  journal={Journal of Neurology, Neurosurgery \& Psychiatry},
  year={1990},
  volume={53},
  pages={101 - 96}
}
Apomorphine a dopamine receptor agonist was given subcutaneously to 57 levodopa treated parkinsonian patients with refractory off-period disabilities for a median period of 16 months. In 30 given intermittent suprathreshold injections the mean number of hours spent in a disabling off state fell from 6.9 to 2.9. Similar benefit was observed in 21 patients receiving continuous infusions with additional boluses on demand by mini-pump (mean reduction of hours off from 9.9 to 4.5). Twelve patients… Expand
Subcutaneous apomorphine in parkinson's disease: Response to chronic administration for up to five years
TLDR
Subcutaneous apomorphine, administered by continuous waking‐day infusion with boluses, or by repeated intermittent injection, represents a significant therapeutic advance in the management of late‐stage Parkinson's disease and should certainly be considered before experimental implantation procedures. Expand
Apomorphine in patients with Parkinson's disease.
TLDR
Apomorphine test appears very useful for the differential diagnosis between idiopathic Parkinson's disease and other Parkinson plus syndromes, and as a predictive test for dopaminergic responsiveness, as well as a pharmacological tool for clinical research with the aim of a better understanding of the pathophysiology of Parkinson’s disease. Expand
Efficacy of Intranasal Apomorphine in Parkinson's Disease
TLDR
Intranasal apomorphine is a comfortable and easy alternative to subcutaneous apomorphicine in the treatment of off phases in patients with Parkinson's disease and severe refractory motor fluctuations. Expand
Apomorphine monotherapy in the treatment of refractory motor complications of Parkinson's disease: Long‐term follow‐up study of 64 patients
TLDR
It is confirmed that subcutaneous apomorphine monotherapy can reset peak‐dose dyskinesia threshold in levodopa‐treated patients and further reduce off‐period disability after all available forms of oral medication, including long‐acting dopamine agonists, have been tried. Expand
Subcutaneous continuous apomorphine infusion in fluctuating patients with Parkinson's disease: long-term results
TLDR
Clinical data of 30 PD patients having at least five years of treatment with subcutaneous continuous apomorphine infusion are reported, showing that Apomorphine is a potent water-soluble dopamine receptor agonist that has been shown to successfully control motor fluctuation when subcutaneously infused in complicated parkinsonian patients. Expand
Intravenous apomorphine therapy in Parkinson's disease: clinical and pharmacokinetic observations.
TLDR
Even when stable plasma apomorphine concentrations were achieved, motor fluctuations could not be totally eradicated, suggesting that postsynaptic receptor changes may also play a role in the refractory 'off' periods in these patients. Expand
Pen injected apomorphine against off phenomena in late Parkinson's disease: a double blind, placebo controlled study.
TLDR
It is concluded that pen injected apomorphine is a valuable treatment for patients with advanced Parkinson's disease with on-off phenomena. Expand
Subcutaneous apomorphine infusion in Parkinson's disease: does it have a role?
TLDR
The experience with apomorphine in treating the 'on/off' phenomenon in L-dopa responsive idiopathic Parkinson's disease is reported, with good response in four patients, fair in two, unchanged in five and worse in two. Expand
Subcutaneous apomorphine in late stage Parkinson’s disease: a long term follow up
TLDR
Subcutaneous apomorphine is a highly effective treatment which can substantially improve the symptomatology in patients with advanced stage Parkinson’s disease over a prolonged period of time. Expand
Apomorphine Infusion and the Long-Duration Response to Levodopa in Advanced Parkinson's Disease
TLDR
The authors conclude that the clinical effect of apomorphine is sustained by levodopa long-duration response, probably the result of postsynaptic mechanisms. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 27 REFERENCES
SUBCUTANEOUS APOMORPHINE IN PARKINSONIAN ON-OFF OSCILLATIONS
TLDR
Results confirm that during off periods dopamine receptors remain responsive to stimulation and provide evidence of a new, effective, and well-tolerated treatment for the most disabling complication of long-term levodopa therapy. Expand
Treatment of Parkinson's disease with aporphines. Possible role of growth hormone.
TLDR
N-propylnoraporphine is very useful in the treatment of Parkinson's disease and seems to abolish tachyphylaxis, in patients previously on prolonged levodopa administration. Expand
Low dosages of bromocriptine added to levodopa in Parkinson's disease
TLDR
The wearing-off effect, off-dose abnormal involuntary movements, and leg pains, associated with levodopa, improved in over 70% of patients at an average dosage of 13 mg, and improvement was greatest in patients with mild disease. Expand
Injected apomorphine and orally administered levodopa in Parkinsonism.
TLDR
The dichotomy between synergistic and antagonistic effects may be explained by the molecule of apomorphine, part of which resembles dopamine and the other resembles phenylethylamine, which can displace neurotransmitters from cellular sites. Expand
BROMOCRIPTINE ASSOCIATED WITH A PERIPHERAL DOPAMINE BLOCKING AGENT IN TREATMENT OF PARKINSON'S DISEASE
TLDR
Peripheral blockade of dopamine receptors is a promising means of limiting the adverse side-effects of the treatment of parkinsonism with central dopaminergic receptor stimulating agents such as bromocriptine. Expand
On-off fluctuations in Parkinson's disease. A clinical and neuropharmacological study.
TLDR
It is concluded that the development of a sustained-release formulation of levodopa would lead to improved control of the response fluctuations seen with conventional levodOPA preparations. Expand
IMPLICATIONS OF COMBINED TREATMENT WITH 'MADOPAR' AND L-DEPRENIL IN PARKINSON'S DISEASE A Long-term Study
TLDR
It is suggested that L-deprenil may act through inhibition of brain M.A.O. as well as by a psychostimulant effect similar to that of amphetamine which occurs through the release of dopamine to make more dopamine available at dopamine receptor sites. Expand
THERAPEUTIC EFFICACY OF APOMORPHINE COMBINED WITH AN EXTRACEREBRAL INHIBITOR OF DOPAMINE RECEPTORS IN PARKINSON'S DISEASE
Apomorphine in combination with a peripheral dopamine receptor blocker (domeperidone) was administered to four parkinsonian patients in a double-blind placebo-controlled study. The therapeuticExpand
ROLE OF SUBCUTANEOUS APOMORPHINE IN PARKINSONIAN VOIDING DYSFUNCTION
TLDR
Although the effect on detrusor behaviour was variable, subcutaneous apomorphine may be of use in both the assessment and treatment of voiding dysfunction in patients with Parkinson's disease. Expand
Madopar HBS in fluctuating parkinsonian patients: Two‐year treatment
TLDR
Positive results were obtained with new HBS on standard Madopar‐related psychiatric disorders and a general trend of deterioration, compared to the first 3–6 months of HBS treatment, was observed in “off” fluctuations after 1 year. Expand
...
1
2
3
...