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Switching dopamine agonists in advanced Parkinsons disease: is rapid titration preferable to slow?

April 26, 2017advanced agonists dopamine Parkinson's disease preferable rapid slow switching titration

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Switching dopamine agonists in advanced Parkinsons disease: is rapid titration preferable to slow?

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Author(s): Goetz CG, Blasucci L, Stebbins GT Affiliation(s): Department of Neurological Sciences, Rush University/Rush-Presbyterian-St. Luke’s Medical Center, Chicago, IL 60612, USA. Publication date & source: 1999-04-12, Neurology., 52(6):1227-9. Publication type: Clinical Trial; Randomized Controlled Trial BACKGROUND: New dopamine agonists are available, but no study has examined safe and effective ways to switch from one agonist to another. OBJECTIVE: To compare rapid- versus slow-titration schedules for starting a new dopamine agonist in patients already on chronic agonist therapy for Parkinson’s disease. METHODS: Sixteen patients on stable carbidopa/levodopa and a dopamine agonist (bromocriptine or pergolide) switched to pramipexole using a conversion calculation of 1:1 for pergolide dose and 10:1 for bromocriptine dose. Patients were randomized to two titration schedules-either slow titration, following the package insert and taking up to 8 weeks to reach their equivalent dosage