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Pergolide
General information
Pergolide is a dopamine receptor agonist, who adverse effects and reactions resemble those of bromocriptine [ ].
Drug studies
Observational studies
In 41 patients with Parkinson’s disease who took pergolide, confusion and hallucinations were the adverse reactions that were most likely to result in withdrawal of pergolide [ ]. Symptoms suggestive of dose-related angina pectoris occurred in four patients in the open phase and two patients in the earlier double-blind phase; these symptoms were easily controlled by dosage reduction or withdrawal of pergolide without sequelae. There was leukopenia in one patient.
Comparative studies
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 reactions. 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.
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