Portal de Periódicos da CAPES

Early combination therapy with bromocriptine and levodopa in parkinson's disease

1993; Wiley; Volume: 8; Issue: 3 Linguagem: Inglês

10.1002/mds.870080302

1531-8257

Stewart A. Factor, William J. Weiner,

Glycogen Storage Diseases and Myoclonus

Abstract The use of early combination therapy with bromocriptine (Br) and levodopa (LD) in Parkinson's disease is controversial. It has been suggested that treatment with this regimen would prevent or delay the onset of motor fluctuations and dyskinesia. Thus, some have recommended it as a standard of care. This recommendation is based on the theory that LD may accelerate the progression of PD and clinical experience using Br monotherapy in early Parkinson's disease, which suggested that Br causes fewer late complications. This article reviews these arguments and shows that the theories are uproven. A single, uncontrolled trial is often referred to as evidence for efficacy of early combination therapy. We critically review this and five other studies which have evaluated the treatment strategy. We show that the literature is often misleading and that these trials do not support the efficacy of early combination therapy. We conclude that there is no justifiable reason to use a combination of Br and LD in early parkinsonian patients.