ergoline and Sleep-Wake-Disorders

Restless legs syndrome (RLS) is a common neurological disorder characterized by an urge to move the legs. The symptoms show a strong circadian rhythmicity, with onset or increase in the evening or at night; thus, sleep disturbances are the most frequent reason for patients seeking medical aid. The prevalence of the disorder increases strongly with age, with an estimated 9% to 20% of sufferers being among the elderly. Dopaminergic drugs are the first-line treatment option in RLS; opioids and anticonvulsants can also be used either as add-on or stand alone therapy options. Secondary forms of RLS and possible interaction with other medications require particular consideration in the elderly.

Topics: Aged, 80 and over; Benzothiazoles; Cabergoline; Circadian Rhythm; Cognition Disorders; Comorbidity; Diagnosis, Differential; Dopamine Agonists; Ergolines; Humans; Indoles; Polysomnography; Pramipexole; Prevalence; Restless Legs Syndrome; Sleep Wake Disorders

Twenty-six patients with late-stage Parkinson disease were given 0.4 to 15 mg of pergolide mesylate daily in addition to, or as replacement for, levodopa or bromocriptine therapy. Despite treatment with individually determined optimum doses of levodopa, bromocriptine, and anticholinergics, they had shown response failure or fluctuating response. Forty percent (11 patients) were unable to tolerate pergolide. Nausea and vomiting, somnolence, and psychiatric disturbances were the most frequent side effects. Eleven of the remaining patients improved on pergolide, 2 were unchanged, and 2 were slightly worse. Among the patients who benefited, pergolide improved dose-related response fluctuations more than non-dose-related fluctuations, with a reduction in number and duration of "off" periods and improvement in quality of sleep and early morning akinesia but little change in freezing episodes. Despite treatment failure in many cases, pergolide is at present the best available drug for specific late-stage management problems.

Topics: Bromocriptine; Clinical Trials as Topic; Double-Blind Method; Drug Therapy, Combination; Ergolines; Female; Humans; Levodopa; Male; Middle Aged; Parkinson Disease; Pergolide; Sleep Wake Disorders

In a previous study, the sleep pattern in Parkinson's disease patients was found to be altered. The disturbance consisted of a "light fragmented sleep pattern" with increased muscle activity. Using a combined polysomnographic and electromyographic recording technique, we found that a reversal of the light fragmented sleep pattern and normalization of muscle activity during sleep occurred after clinical improvement with dopaminergic treatment. The effect of dopaminergic treatment on sleep disturbance was analyzed. There is an intimate relationship between sleep pattern and the normalization of sleep muscle activity produced by dopaminergic agents.

Topics: Aged; Carbidopa; Drug Combinations; Ergolines; Female; Humans; Levodopa; Male; Middle Aged; Parkinson Disease; Pergolide; Receptors, Dopamine; Sleep Wake Disorders; Sleep, REM

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

Topics: Aged; Antiparkinson Agents; Cognition Disorders; Epilepsy, Temporal Lobe; Ergolines; Grief; Humans; Lisuride; Male; Middle Aged; Pergolide; Schizophrenic Psychology; Sleep Wake Disorders