Cabergoline

General information

Cabergoline is an ergoline derivative that has been used in patients with hyperprolactinemia [ ], but is used nowadays in patients with Parkinson’s disease. Adverse reactions include nausea, hypotension, headache, gastric pain, dizziness, and weakness, which as a rule resolve over time.

It is almost universally accepted that directly acting dopamine receptor agonists have less efficacy than levodopa, although the reasons are not clear. Neurologists from London have sought to question this assumption by using cabergoline (n = 11) and pergolide (n = 7) at considerably higher doses than recommended [ ]. The actual mean doses were 8.8 and 9.4 mg/day, compared with recommended maxima of 6 and 5 mg/day respectively. The high doses were tolerated by the patients for 2.3–2.5 years; mild dyskinesias (n = 7), ankle edema (n = 3), and hallucinations (n = 1) were the only reported adverse effects. The authors concluded that the therapeutic window for these drugs is apparently much greater than is generally accepted, and that higher doses can be given safely with potentially enhanced efficacy.