Safety considerations when using non-ergot dopamine agonists to treat Parkinson's disease

Expert Opin Drug Saf. 2020 Sep;19(9):1155-1172. doi: 10.1080/14740338.2020.1804550. Epub 2020 Oct 3.

Abstract

Introduction: Nonergot dopamine agonists (NEDA) represent an excellent treatment option for Parkinson's disease (PD) patients, in both early and advanced stages of the disease. The post-marketing phase of NEDA has highlighted, though, the occurrence of important long-term adverse events.

Areas covered: This review reports recent updates on NEDA adverse events, analyzing neurobiological bases and risk factors of these complications. A literature search has been performed using Medline and reviewing the bibliographies of selected articles.

Expert opinion: NEDA represents a very important option in the treatment of PD. Criticisms on their use can be overcome through a better knowledge of these molecules and of the risk factors for adverse events which allow specialists to prevent the occurrence of undesired complications and consent a tailor-based approach. Abbreviations: PD: Parkinson's disease, DA: dopamine agonists, NEDA: non-ergot dopamine agonists, ICD: impulse control disorders, DAWS: dopamine agonist withdrawal syndrome, CYP: Cytochrome P, PK: pharmacokinetic, AUC: area under the curve, HRT: hormone replacement therapy, AV: atrioventricular, HF: heart failure, OH: orthostatic hypotension, RBD: REM behavior disorders, PDP: Parkinson's disease psychosis, DRT: dopamine replacement therapy, DDS: dopamine dysregulation syndrome, MMSE: Mini-Mental state examination, EDS: excessive daytime somnolence.

Keywords: Dopamine agonists; heart failure; impulse control disorders; non ergot derivatives; parkinson’s disease; safety; safety3; side effects.

Publication types

  • Review

MeSH terms

  • Animals
  • Antiparkinson Agents / administration & dosage
  • Antiparkinson Agents / adverse effects*
  • Dopamine Agonists / administration & dosage
  • Dopamine Agonists / adverse effects*
  • Humans
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / physiopathology
  • Risk Factors

Substances

  • Antiparkinson Agents
  • Dopamine Agonists