ergoline and Hallucinations

To assess the efficacy and safety of the dopamine agonist cabergoline (CAB) in patients with restless legs syndrome (RLS).. Patients with moderate to severe RLS were randomized into four groups receiving placebo, 0.5 mg, 1 mg, or 2 mg CAB once daily in a double-blind, placebo-controlled, multicenter dose-finding trial followed by an open long-term extension trial of 47 weeks. Efficacy was assessed with the RLS-6 scales and International RLS Study Group severity scale (IRLS).. A total of 85 patients (age 56 +/- 10 years, 71% females) were treated. Severity of RLS-6 scale symptoms during the night (the primary endpoint) was markedly improved by all CAB doses compared to placebo (placebo: -1.4 +/- 3.1, 0.5 mg CAB: -4.2 +/- 3.0 [p = 0.0082], 1.0 mg CAB: -4.0 +/- 2.9 [p = 0.0040], 2.0 mg CAB: -4.8 +/- 3.7 [p = 0.0026]). Similar results were found for the RLS severity at bedtime and during the day, IRLS, and satisfaction with sleep. A stable, clinically relevant improvement was achieved in all efficacy measures (severity during the night: change between last assessment and baseline: -5.6 +/- 2.5, rate of remission: 71.2%) throughout 1 year with a mean CAB dose of 2.2 mg per day. During long-term treatment, 6 of 66 treated patients were affected (n = 2) or possibly affected (n = 4) by mild augmentation. Under CAB therapy up to 1 year, 11 of 85 patients discontinued treatment due to a drug-related adverse event.. Cabergoline is an efficacious and well-tolerated option for the treatment of restless legs symptoms during the night and the day.

Topics: Aged; Cabergoline; Dopamine Agonists; Dose-Response Relationship, Drug; Double-Blind Method; Ergolines; Female; Gastrointestinal Diseases; Hallucinations; Humans; Male; Middle Aged; Nervous System Diseases; Prospective Studies; Restless Legs Syndrome; Severity of Illness Index; Treatment Outcome

Topics: Adult; Aged; Clinical Trials as Topic; Dopamine; Double-Blind Method; Dystonia; Ergolines; Female; Hallucinations; Humans; Lisuride; Male; Middle Aged; Nausea; Paranoid Disorders

Nine patients with various focal dystonias participated in a 12-week, double-blind, crossover comparison of the dopamine agonist, lisuride, and placebo. Lisuride produced mild objective and subjective improvement in six subjects, but the improvement was not sustained with continued therapy. Because the patients generally identified the active drug by side effects, biasing the study toward finding an effect, and because the benefits were mild and transient, we conclude that lisuride is of limited use in the treatment of focal dystonias.

Topics: Adult; Aged; Clinical Trials as Topic; Double-Blind Method; Dystonia; Ergolines; Female; Hallucinations; Humans; Lisuride; Male; Middle Aged; Nausea; Random Allocation

Topics: Adult; Antipsychotic Agents; Cabergoline; Cesarean Section; Dopamine Agonists; Ergolines; Female; Hallucinations; Humans; Lactation; Postoperative Complications; Pregnancy; Pregnancy Complications; Pregnancy, Twin; Psychomotor Agitation; Psychotic Disorders; Puerperal Disorders; Risperidone; Sleep Initiation and Maintenance Disorders

Psychosis characterized by hallucination or delusion, which occurs during drug therapy of parkinsonian patients, is one of the limiting factors for the control of motor symptoms or complications. In the present study, we encountered three patients with Parkinson's disease (PD) at advanced stages; all three patients had severe psychosis and severe wearing-off phenomenon and one had severe orthostatic hypotension. Their psychotic symptoms were successfully treated by administration of quetiapine, resulting in the favorable control of motor fluctuations and elevation of therapeutic levels unless any aggravation of parkinsonism occurs. Although the measure against drug-induced psychosis is principally a reduction of the doses or withdrawal of causative drugs, the effective use of antipsychotic drugs, such as quetiapine, is helpful to suppress psychosis and allow the patient to adjust to antiparkinsonian drugs for the control of symptoms other than psychosis.

Topics: Aged; Antiparkinson Agents; Antipsychotic Agents; Cabergoline; Dibenzothiazepines; Ergolines; Hallucinations; Humans; Levodopa; Male; Middle Aged; Parkinson Disease; Psychoses, Substance-Induced; Quetiapine Fumarate

The D2 dopamine (DA) receptor agonist, quinpirole, was characterized in young adult monkeys, young reserpine-treated monkeys and aged monkeys to assess the contribution of DA to age-related loss of prefrontal cortical (PFC) cognitive function. Monkeys were tested on a delayed response memory task that depends on the PFC, and a fine motor task that taps the functions of the motor cortex. In young adult monkeys, low quinpirole doses impaired performance of the PFC and fine motor tasks, while higher doses improved memory performance and induced dyskinesias and "hallucinatory-like" behaviors. The pattern of the quinpirole response in reserpine-treated monkeys suggested that the impairments in delayed response and fine motor performance resulted from drug actions at D2 autoreceptors, while the improvement in delayed response performance, dyskinesias and "hallucinatory-like" behaviors resulted from actions at postsynaptic receptors. In aged monkeys, low doses of quinpirole continued to impair fine motor performance, but lost their ability to impair delayed response performance. The magnitude of cognitive improvement and the incidence of "hallucinatory-like" behaviors were also reduced in the aged animals, suggesting some loss of postsynaptic D2 receptor function. The pattern of results is consistent with the greater loss of DA from the PFC than from motor areas in aged monkey brain (Goldman-Rakic and Brown, 1981; Wenk et al., 1989), and indicates that DA depletion contributes significantly to age-related cognitive decline.

Topics: Aging; Animals; Dopamine Agonists; Dose-Response Relationship, Drug; Ergolines; Female; Hallucinations; Macaca mulatta; Memory; Prefrontal Cortex; Psychomotor Performance; Quinpirole; Reaction Time; Receptors, Dopamine D2; Reserpine; Synapses

Topics: Ergolines; Hallucinations; Humans; Lisuride; Paranoid Disorders; Parkinson Disease

We used pergolide to treat 10 patients with idiopathic Parkinson's disease who had first responded to, and then failed, bromocriptine therapy. At the end of 5 years, patients had improved when compared with study entry. Peak efficacy, equal with both drugs, was seen at 12 months. After a mean treatment of 29 months, bromocriptine was no longer effective, but pergolide was still beneficial.

Topics: Aged; Antiparkinson Agents; Bromocriptine; Drug Therapy, Combination; Dyskinesia, Drug-Induced; Dystonia; Ergolines; Female; Hallucinations; Humans; Levodopa; Male; Middle Aged; Nausea; Outcome and Process Assessment, Health Care; Parkinson Disease; Pergolide; Time Factors

Topics: Aged; Bromocriptine; Confusion; Depression; Ergolines; Female; Hallucinations; Humans; Male; Mental Disorders; Middle Aged; Neurocognitive Disorders; Parkinson Disease; Schizophrenia, Paranoid

Topics: Animals; Brain; Cyclic AMP; Dopamine; Ergolines; Hallucinations; Homovanillic Acid; Humans; Hydroxyindoleacetic Acid; Lysergic Acid Diethylamide; Male; Monoamine Oxidase; Norepinephrine; Rats; Receptors, Serotonin; Serotonin; Urea