Apomorphine infusional therapy in parkinson's disease: Clinical utility and lack of tolerance

Stephen T. Gancher, John G. Nutt, William R. Woodward

Research output: Contribution to journalArticle

94 Scopus citations

Abstract

We assessed the clinical utility of apomorphine infusional therapy in patients with parkinsonism and motor fluctuations and sought evidence for alterations in drug response resulting from chronic treatment. Six patients with Parkinson's disease were treated for 3 months with s. c. infusions of apomorphine administered during waking hours. At the beginning and the end of the study, test doses of apomorphine (12.5–100 μg/kg) were administered to establish a dose‐response curve. Over the study, the patients reported a significant improvement in the number of “on” hours experienced per day and substantially reduced the dose and frequency of levodopa and other antiparkinsonian medications. No average change in apomorphine dose‐response relationships or pharmacokinetics was observed during the study. However, two patients lowered the infusion rate during the 3‐month observation and exhibited higher drug levels and longer responses following test doses of apomorphine given at the end of the study. Although pragmatic concerns with the use of infusion pumps solutions and adverse effects limited the overall benefit afforded by the treatment, this kind of drug treatment may be useful in selected patients with severe parkinsonism and fluctuations.

Original languageEnglish (US)
Pages (from-to)37-43
Number of pages7
JournalMovement Disorders
Volume10
Issue number1
DOIs
StatePublished - Jan 1995

Keywords

  • Apomorphine
  • Infusional therapy
  • Parkinson's disease
  • Sensitization
  • Tolerance

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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