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Long-term efficacy and safety with continuous dopaminergic stimulation pump treatments in Parkinson's disease
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.
2011 (English)In: European Neurological Review, ISSN 1758-3837, Vol. 6, no 3, 156-160 p.Article in journal (Refereed) Published
Abstract [en]

Continuous dopaminergic stimulation (CDS) is important for symptom control in advanced stages of Parkinson’s disease (PD). The most efficacious approaches are pump treatments with dopaminergic drugs: subcutaneous infusion of the dopamine receptor agonist apomorphine and intestinal infusion of levodopa/carbidopa gel. Both methods decrease motor fluctuations in long-term follow-ups, including parkinsonian and dyskinetic states, when compared to conventional optimised oral therapy. Also non-motor symptoms may be improved. Adverse drug reactions are usually less pronounced although high levodopa doses, which are common with levodopa/carbidopa infusion, may cause hyperhomocysteinaemia and cobalamin deficiency. Technical complications are specific for each infusion strategy. Formation of subcutaneous nodules is the most common problem with apomorphine infusion. Dislocation of the intestinal tube is the most common problem with levodopa/carbidopa infusion. Both pump treatments may be used for 24-hour infusion in selected patients. The long-term experience is reviewed. To conclude, CDS pump treatments may be successfully used for several years in advanced PD.

Place, publisher, year, edition, pages
2011. Vol. 6, no 3, 156-160 p.
National Category
Neurology
Research subject
Neurology
Identifiers
URN: urn:nbn:se:uu:diva-160301OAI: oai:DiVA.org:uu-160301DiVA: diva2:450364
Available from: 2011-10-20 Created: 2011-10-20 Last updated: 2014-09-10Bibliographically approved

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