Comparison of the clinical pharmacology of (-)NPA and levodopa in Parkinson's disease

M. M. Mouradian, I. J.E. Heuser, F. Baronti, M. Giuffra, K. Conant, T. L. Davis, T. N. Chase

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Direct acting dopamine agonists are generally less effective than levodopa in relieving symptoms of Parkinson's disease. In an attempt to quantitate and explain this situation, the acute motor responses to intravenous injections of the dopamine agonist, (-)-N-n-propyl-norapomorphine hydrochloride (NPA), were compared with those of the dopamine precursor, levodopa. At optimum dose levels, the acute anti-Parkinsonian efficacy of NPA averaged only about 50% of maximum, while essentially total symptom suppression was obtained with levodopa in patients previously treated with the amine precursor. Dyskinesia severity, however, was similar with the two drugs. These differences in anti-Parkinsonian efficacy may reflect the fact that while NPA acts mainly on D-2 dopamine receptors, levodopa results in stimulation of both the D-1 and D-2 subsets of receptors at a more physiological ratio. Future efforts to develop dopamine agonists for the treatment of Parkinsonian symptoms may thus have to consider focusing on drugs having pharmacological profile more similar to that of dopamine.

Original languageEnglish (US)
Pages (from-to)401-405
Number of pages5
JournalJournal of Neurology Neurosurgery and Psychiatry
Volume54
Issue number5
DOIs
StatePublished - 1991
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology
  • Psychiatry and Mental health

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