Subcutaneous apomorphine in Parkinson's disease: response to chronic administration for up to five years

Mov Disord. 1993 Apr;8(2):165-70. doi: 10.1002/mds.870080208.

Abstract

Subcutaneous apomorphine, administered by continuous waking-day infusion with boluses, or by repeated intermittent injection, was given to 71 parkinsonian patients with severe refractory levodopa related on-off fluctuations for 1-5 years. A mean reduction in daily off period time of approximately 50% was maintained, and the incidence of neuropsychiatric toxicity remained low on long-term follow-up. No clinically significant tolerance or loss of therapeutic effect was seen, although increasingly severe on-phase dyskinesias and postural instability marred the long-term therapeutic response in many patients. Despite these drawbacks, apomorphine, when combined with the peripheral dopamine receptor agonist domperidone, represents a significant therapeutic advance in the management of late-stage Parkinson's disease and should certainly be considered before experimental implantation procedures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Apomorphine / administration & dosage*
  • Apomorphine / adverse effects
  • Female
  • Follow-Up Studies
  • Humans
  • Infusion Pumps
  • Injections, Subcutaneous
  • Levodopa / administration & dosage
  • Levodopa / adverse effects
  • Long-Term Care
  • Male
  • Middle Aged
  • Neurologic Examination / drug effects
  • Parkinson Disease / drug therapy*

Substances

  • Levodopa
  • Apomorphine