Ahlskog J Eric
Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Curr Neurol Neurosci Rep. 2003 Jul;3(4):289-95. doi: 10.1007/s11910-003-0005-1.
Recent studies have suggested that initial dopamine agonist therapy with pramipexole or ropinirole may slow the progression of Parkinson's disease (PD) and also reduce the subsequent risk of levodopa motor complications. This presumed effect on PD progression, however, could be artifactual, resulting from the influence of chronic drug treatment on regulation of dopamine system proteins. With respect to levodopa motor complications, there is no dispute that pramipexole and ropinirole are effective in reducing levodopa dyskinesias and motor fluctuations; however, it is not clear that they must be started early, as opposed to initiation only after the levodopa complications develop. Levodopa therapy has numerous advantages that include greater efficacy, much lesser expense, simpler administration, and a lower frequency of hallucinosis and somnolence. Carbidopa/levodopa, pramipexole, and ropinirole are all appropriate first choices in the treatment of PD.
最近的研究表明，初始使用普拉克索或罗匹尼罗的多巴胺激动剂疗法可能会减缓帕金森病（PD）的进展，并降低随后出现左旋多巴运动并发症的风险。然而，这种对PD进展的假定作用可能是人为的，是慢性药物治疗对多巴胺系统蛋白质调节的影响所致。关于左旋多巴运动并发症，毫无疑问，普拉克索和罗匹尼罗在减少左旋多巴异动症和运动波动方面是有效的；然而，尚不清楚它们是否必须早期开始使用，与仅在左旋多巴并发症出现后才开始使用相对。左旋多巴疗法有许多优点，包括更高的疗效、更低的费用、更简单的给药方式以及更低的幻觉和嗜睡发生率。卡比多巴/左旋多巴、普拉克索和罗匹尼罗都是治疗PD的合适首选药物。
