Intranasal apomorphine rescue therapy for parkinsonian "off" periods

Clin Neuropharmacol. 1996 Jun;19(3):193-201. doi: 10.1097/00002826-199619030-00001.


Eleven patients with levodopa-related motor fluctuations were scored before and after intranasal apomorphine monotherapy, and the motor responses were compared with those with levodopa/carbidopa in this openlabel study. Oral trimethobenzamide was used to prevent apomorphine-induced nausea. Three measures of motor performance were employed: (a) the Unified Parkinson's Disease Rating Scale (UPDRS) motor battery; (b) a timed hand-tapping test; and (c) the Webster's step-seconds test. The magnitude of the motor-score improvement after apomorphine administration was very similar to that after the usual doses of levodopa/carbidopa in the 10 patients completing the study; this was true for all three outcome measures. A major advantage of apomorphine was the rapid onset of clinical response, which typically occurred in < 10 min, as well as the ease of administration. Major side effects, beyond those experienced with levodopa/carbidopa, were limited to nausea and vomiting (three patients) and orthostatic hypotension (one patient); however, only a single patient dropped out of the study as a consequence. These results indicate that intranasal apomorphine is effective in rapidly relieving parkinsonian "off" states and that, for most patients, trimethobenzamide is an effective and well-tolerated antiemetic for use with apomorphine.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intranasal
  • Antiemetics / therapeutic use
  • Antiparkinson Agents / adverse effects
  • Antiparkinson Agents / therapeutic use*
  • Apomorphine / adverse effects
  • Apomorphine / therapeutic use*
  • Benzamides / therapeutic use
  • Carbidopa / therapeutic use
  • Dopamine Agonists / adverse effects
  • Dopamine Agonists / therapeutic use*
  • Female
  • Humans
  • Hypotension, Orthostatic / chemically induced
  • Levodopa / therapeutic use
  • Male
  • Middle Aged
  • Nausea / chemically induced
  • Parkinson Disease / drug therapy*
  • Vomiting / chemically induced


  • Antiemetics
  • Antiparkinson Agents
  • Benzamides
  • Dopamine Agonists
  • Levodopa
  • Carbidopa
  • Apomorphine
  • trimethobenzamide