Department for Parkinson Disease, IRCCS San Camillo, Venice, Italy.
CNS Drugs. 2010 Oct;24(10):829-41. doi: 10.2165/11585090-000000000-00000.
The non-ergot dopamine agonist pramipexole is currently indicated for the treatment of the signs and symptoms of idiopathic Parkinson's disease and for the treatment of moderate-to-severe primary restless legs syndrome. A new extended-release formulation of pramipexole has now also been launched in Europe and the US to improve ease of use, compliance and provide a more continuous therapeutic effect over 24 hours. Before initiating any treatment, the benefit-risk ratio to the individual patient must be considered. For pramipexole in the treatment of Parkinson's disease, this means taking into account the available evidence regarding its symptomatic efficacy, effect on delaying long-term levodopa-related motor complications, beneficial effect on non-motor symptoms such as depression, and its safety and tolerability profile. Studies have shown that pramipexole is effective as monotherapy in early Parkinson's disease and as adjunctive therapy in advanced disease. Trials further suggest that the benefits of pramipexole may extend beyond the relief of motor symptoms (akinesia, rigidity and tremor at rest) to the amelioration of depressive symptoms in Parkinson's disease. Pramipexole is generally well tolerated; however, compared with levodopa treatment, pramipexole is associated with a higher rate of some dopaminergic adverse effects.
目前，非麦角类多巴胺激动剂普拉克索被用于治疗特发性帕金森病的体征和症状，以及中重度原发性不安腿综合征。一种新的普拉克索缓释制剂现已在欧洲和美国推出，以提高使用便利性、顺应性，并提供 24 小时更持续的治疗效果。在开始任何治疗之前，必须考虑对个体患者的获益-风险比。对于帕金森病的普拉克索治疗，这意味着要考虑到其症状缓解效果、对长期与左旋多巴相关的运动并发症的延迟作用、对非运动症状（如抑郁）的有益作用，以及其安全性和耐受性特征的相关证据。研究表明，普拉克索在早期帕金森病中作为单药治疗有效，在晚期疾病中作为辅助治疗有效。进一步的试验表明，普拉克索的益处可能不仅限于缓解运动症状（运动不能、强直和静止性震颤），还可能改善帕金森病的抑郁症状。普拉克索通常具有良好的耐受性；然而，与左旋多巴治疗相比，普拉克索与一些多巴胺能不良反应的发生率更高有关。
