Evaluation of the Efficacy of Pramipexole for Treating Levodopa-induced Dyskinesia in Patients with Parkinson's Disease

Objective The long-term use of levodopa to treat Parkinson's disease (PD) is often limited by the development of motor complications (e.g. levodopa-induced dyskinesia, LID). We hypothesized that a non-ergot dopamine agonist with strong affinity for D-3 dopamine receptors (pramipexole) may improve LID in patients taking an ergot D-1/D-2 dopamine agonist. Methods Patients with PD and LID being treated with levodopa in addition to an ergot dopamine agonist were randomized to either a group in which pramipexole was added to current medications or a group in which the ergot dopamine agonist was switched to pramipexole. Dyskinesia was evaluated using Core Assessment Program for Surgical Interventional Therapies scores. The Unified Parkinson's Disease Rating Scale scores, Modified Hoehn and Yahr stages (at 'on' time), Parkinson's Disease Questionnaire-39 scores and Clinical Global Impression-Improvement scores were also used for evaluation. Results At 24 weeks, pramipexole alleviated LID with more efficiency in the switch group. Conclusion Pramipexole may be a therapeutic option for treating LID because its effects on D-3 dopamine receptors may balance the D-1 dopamine receptor supersensitivity associated with LID.