ergoline and Hypotension

Nine patients suffering from Parkinson's disease and 2 cases of Parkinsonian syndrome were treated with bromocriptine, for 41 to 117 days, with a daily dose of 20 to 40 mg. The results were very good in 4 cases, satisfactory in 6 and nil in one case. Improvement concerned akinesias, rigidity and tremor, and was more marked in patients with more advanced signs. In 2 patients, amantadine was stopped. The dose of L-dopa was decreased by 2/3 without any change in clinical condition and L-dopa could be withdrawn in 5 cases out of 8. Bromocriptine appears to be an interesting development in the treatment of Parkinson's disease.

Topics: Aged; Amantadine; Bromocriptine; Clinical Trials as Topic; Drug Evaluation; Ergolines; Female; Humans; Hypotension; Levodopa; Male; Movement Disorders; Nausea; Parkinson Disease, Secondary

The hemodynamic and biochemical effects of cabergoline, a new ergoline derivative with selective, potent, and long-lasting dopamine (DA) agonistic properties, were evaluated in 19 parkinsonian patients, all previously identified as stable responders to levodopa plus L-Dopa decarboxylase inhibitor. The purpose of the study was to find markers capable of predicting the development of cardiopressor side effects during DA-agonistic therapy. Blood pressure (BP), heart rate, and plasma catecholamine responses to a standard meal and a tilt table test were evaluated before and during cabergoline therapy. Cabergoline (1.0 mg/day x os) in this open study significantly reduced the BP response to standing exclusively in the subgroup of patients who exhibited marked postprandial hypotension in baseline conditions. The patients subsequently experienced a partial recovery at day 7 of treatment. This finding indicates that postprandial hypotension is an early marker of autonomic failure in patients with Parkinson's disease (PD) and suggests the usefulness of evaluating cardiopressor response to a standard meal before starting new DA-agonist therapy in PD.

Topics: Aged; Blood Pressure; Cabergoline; Dopamine Agents; Ergolines; Female; Food; Heart Rate; Humans; Hypotension; Hypotension, Orthostatic; Male; Middle Aged; Parkinson Disease; Time Factors

Thirteen patients with idiopathic Parkinson's disease and "on-off" fluctuations on oral levodopa plus dopa decarboxylase inhibitor (DDI) were treated with continuous (24 hour) subcutaneous lisuride infusions together with a reduced dose of levodopa (plus DDI). An improvement in motor performance was seen in 10 patients, with a mean increase in percentage of waking time spent "on" of 32 per cent (range 13-59 percent). However, adverse effects were common, especially psychiatric effects, leading to treatment withdrawal in 11 of 13 subjects after a mean of 40 days' treatment. Continuous lisuride infusion together with a small dose of levodopa (plus DDI) are effective treatment for "on-off" fluctuations in Parkinson's disease, but the frequency of adverse effects limits the number of patients who can be treated successfully with this technique.

Topics: Adult; Aged; Drug Eruptions; Dyskinesia, Drug-Induced; Ergolines; Female; Humans; Hypotension; Infusion Pumps; Lisuride; Male; Mental Disorders; Middle Aged; Movement; Parkinson Disease

Preliminary studies indicate that nicergoline, a new alpha-antagonist, can lower HR at doses which decrease arterial BP. The present animal study was designed to quantitate the systemic and carotid (pulsed Doppler) hemodynamic and renin release consequences of nicergoline ventricular unloading, and to investigate the hemodynamic mechanisms of hypotension. In 11 anesthetized dogs, nicergoline infusion induced progressive, moderate, and prolonged hypotension associated with reduced vascular resistance and capacitance. Hypotension resulted from decreased HR and cardiac output, without an increase in plasma renin activity. The effects on carotid hemodynamics were less marked than those on the systemic circulation. Hypotension was caused primarily by vasoplegia, and was magnified subsequently by inhibition of the reflex rapid pressor control mechanisms. This suggests that repeated iv doses of nicergoline are preferable to prolonged infusion.

Topics: Animals; Dogs; Drug Evaluation, Preclinical; Ergolines; Female; Heart; Hemodynamics; Hypotension; Infusions, Parenteral; Male; Nicergoline; Radioimmunoassay; Renin

This study was designed to compare at the same level of hypotension (-30%) nitroprusside (SNP) and nicergoline (NIC) effects on systemic haemodynamics and carotid haemodynamics (pulsed Doppler) and on plasma renin activity (PRA) in 20 anaesthetized dogs before and at the 20th minute of hypotension. In SNP group (n = 9) cardiac output (CO) and heart rate (HR) increased. Stroke volume (SV), pulmonary wedge pressure (PWP), central venous pressure (CVP) and systemic vascular resistance (SVR) decreased. Common carotid diameter (D) increased and blood flow velocity (V) decreased with constant common carotid blood flow (CCBF). CCBF/CO ratio was unchanged. PRA levels increased. In NIC group (n = II), HR, CO, SV were unchanged and PWP, CVP, SVR decreased. D, V and CCBF were unchanged. CCBF/CO ratio increased and PRA was unchanged. NIC provoked mild hypotension without reflex sympathetic activation unlike SNP. Only SNP dilated large arteries. The autoregulation of CCBF is maintained with both drugs but CCBF/CO ratio is increased only with NIC.

Topics: Anesthesia; Animals; Blood Flow Velocity; Blood Pressure; Cardiac Output; Carotid Arteries; Dogs; Ergolines; Ferricyanides; Heart Rate; Hemodynamics; Hypotension; Nicergoline; Nitroprusside; Renin; Stroke Volume; Vascular Resistance

The tolerance and prolactin (PRL) release-inhibiting action of the 8 alpha-aminoergoline, mesurlergine, were investigated. In a blind crossover study in six subjects with hyperprolactinemia, 0.5 mg mesulergine induced fewer side effects than did 2.5 mg bromocriptine, while the PRL release-inhibiting effect of the two was of the same order. Six different subjects with suspected PRL-secreting pituitary adenomas who (repeatedly) had to discontinue bromocriptine because of nausea, vomiting, or symptoms of orthostatic hypotension were treated for 20 mo with mesulergine (1 to 2 mg/day). Mesulergine did not induce side effects and its actions resembled those of bromocriptine. Mesulergine induced cessation of galactorrhea and resumption of normal menstrual cycles in five subjects, while in one subject an insufficient luteal phase persisted. No abnormalities in routine blood parameter estimations were observed. In two of three subjects there was shrinkage of a pituitary tumor after 12 to 15 mo on mesulergine. Mesulergine did not directly inhibit PRL release by cultured normal rat pituitary cells and human prolactinoma cells and it antagonized the action of dopamine in a dose-dependent manner. This suggests that the dopaminergic action is carried out by a metabolite of mesulergine, while the parent drug probably prevents the well-known side effects of dopamine-agonistic drugs by its dopamine receptor blocking activity. Because of its acceptability, mesulergine might be important in the treatment of hyperprolactinemia and perhaps also of acromegaly and Parkinson's disease.

Topics: Adenoma; Administration, Oral; Adult; Animals; Blood Pressure; Bromocriptine; Cells, Cultured; Dopamine Antagonists; Drug Evaluation; Ergolines; Female; Humans; Hypotension; Male; Menstruation; Middle Aged; Nausea; Pituitary Neoplasms; Prolactin; Radioimmunoassay; Random Allocation; Rats

Topics: Aged; Antiparkinson Agents; Ergolines; Female; Humans; Hypotension; Male; Middle Aged; Nausea; Pain; Parkinson Disease; Pergolide; Spasm

Topics: Adult; Aged; Ergolines; Female; Humans; Hypotension; Lisuride; Male; Mental Disorders; Middle Aged; Nausea; Parkinson Disease; Sleep Wake Disorders; Vertigo; Vomiting

Topics: Athetosis; Carbidopa; Chorea; Drug Combinations; Drug Evaluation; Drug Therapy, Combination; Ergolines; Humans; Hypotension; Levodopa; Male; Middle Aged; Parkinson Disease; Pergolide

Topics: Animals; Blood Pressure; Brain Ischemia; Cats; Cerebrovascular Circulation; Electroencephalography; Ergolines; Homeostasis; Hypertension; Hypotension; Nifedipine; Papaverine; Vasodilation

20 puerperal women who did not wish to breast feed their infants were treated with the serotonin antagonist metergoline. In 19 cases effective suppression of puerperal lactation was achieved by the administration of metergoline without the side effects or signs of intolerance. Of 9 women with hyperprolactinaemic amenorrhoea treated with metergoline the raised prolactin level was lowered, followed by menstruation in 7 patients. Ovulation even occurred in 5 of these women. One patient had to discontinue therapy due to intolerance. in normoprolactinaemic amenorrhoea regular menstruation reappeared in 4 out of 5 women; 2 patients even ovulated.

Topics: Adolescent; Adult; Amenorrhea; Ergolines; Female; Humans; Hypotension; Lactation; Metergoline; Pregnancy; Prolactin; Vomiting

Topics: Animals; Blood Volume; Cats; Cerebrovascular Circulation; Electroencephalography; Ergolines; Hypotension; Papaverine; Partial Pressure

Topics: Acromegaly; Aged; Bromocriptine; Ergolines; Humans; Hypotension; Male

Topics: Adenosine Triphosphate; Adrenergic alpha-Antagonists; Anesthesia; Animals; Bemegride; Brain; Bromine; Carotid Arteries; Cocaine; Dipyridamole; Dogs; Electroencephalography; Energy Transfer; Ergolines; Femoral Artery; Hypoglycemia; Hypotension; Hypoxia; Lactates; Ligation; Male; Malonates; NAD; Nicotinic Acids; Pyruvates; Time Factors; Urethane

Topics: Ergolines; Ergotamine; Female; Humans; Hypotension; Physical Therapy Modalities; Pregnancy; Pregnancy Complications, Cardiovascular