Dyskinesias and treatment with pramipexole in patients with Parkinson's disease

Dopamine agonists such as pramipexole (ppx) have first been proposed as adjunctive treatment to levodopa (l-dopa) for patients with parkinson's disease (pd) and then as a monotherapy alternative to alleviate dyskinesia. treatment with ppx has overall been associated with improvement in parkinsonian symptoms. although the majority of placebo-controlled studies demonstrated that dyskinesia was more prevalent in the ppx compared to the placebo groups,some studies did not detect any dyskinesia as a side effect of this medication. ppx was consistently associated with lower risk for developing dyskinesia compared to l-dopa. moreover,the presence of these symptoms in the placebo groups suggests involvement of non-ppx-related factors for developing dyskinesia. it is suggested that future research should aim at ascertaining whether cotherapy with l-dopa,ppx dosage,and other patient characteristics are contributory factors for the development of ppx-related dyskinesia in patients with pd. © 2012 john c. p. piedad and andrea e. cavanna.