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Re: D1 stimulation question, for the psychopharm b » DStupid

Posted by kingcolon on December 2, 2007, at 23:48:07

In reply to Re: D1 stimulation question, for the psychopharm b » cumulative, posted by DStupid on November 29, 2007, at 22:16:43

> I've been thinking along the same lines, although less specific than you have. I'm in the US and all of the anti-parkinson's drugs available here appear to have bad cardiac side effects. I haven't tried any, but I got that notion from reading their product descriptions. Pergolide was withdrawn from the US market earlier this year because it damaged heart valves.>
> I'm looking into a different type of drug altogether -- bronchodilators -- for improved flow of oxygen to my brain and, hopefully, better mood, improved concentration, etc. So far, I've tried Atrovent, but it was quite powerful for me and I stopped. Am searching for another one.

I just posted a link to the recent article in the NEJM on mitral valve dysfunction with ergot agonists. However, if you look closely, the authors also found abnormal "mitral tenting" with the non ergots (eg, Requip, Mirapex, piribedil and others) which may be a precursor to frank regurgitation, and in their conclusions recommend monitoring patients on ANY dopamine agonist. Frankly, I think we are asking for trouble using even the non-ergots.

From:
Renzo Zanettini, M.D Valvular Heart Disease and the Use of Dopamine Agonists for Parkinson's Disease NEJM Volume 356:39-46 (2007)

In conclusion, we found a significant increase in the risk of heart-valve regurgitation in patients taking ergot-derived dopamine-receptor agonists for Parkinson's disease. The finding of a significantly increased mean mitral tenting area, not only in patients receiving ergot-derived dopamine agonists but also in patients treated with non–ergot-derived dopamine agonists, suggests that follow-up echocardiographic monitoring is advisable in all patients with Parkinson's disease who are treated with dopamine agonists.


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