There are a large variety of
dopamine agonists available. Especially de novo patients are treated with
dopamine agonists to avoid
dyskinesia.
Dopamine agonists can be subdivided into
ergoline and non-
ergoline derivatives. This distinction raises the question whether there are differences in the effects to treat symptoms, not only in the side effects between the individual
dopamine agonists but also between these two groups.
Pergolide is now considered a second line
drug because of its particularly high tendency towards
valvular heart disease. Some authors claim that all
ergoline-derivatives may cause this problem, while own results do not necessarily support this view. We recommend performing echocardiography on those patients being treated with an ergot-derivative. New data support the view that all
dopaminergic drugs may cause
somnolence and that there is no preference for non-ergots. It may be that the number of gamblers is slightly higher among patients treated with
pramipexole than in others.
Dopamine agonists with a high affinity to D3 receptors have a good anti-anhedonic potency. In cell culture all
dopamine agonists studied so far show neuroprotective properties in cell culture. The introduction of a
slow-release formulation for
ropinirole and the
rotigotine and
lisuride patches have opened new ways of continuous
dopamine receptor stimulation. Taken together,
dopamine agonists show individual properties and there are differences between ergot and non-ergot derivatives.