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Academia Mexicana de Neurología, A.C.

2018, Number 3

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Rev Mex Neuroci 2018; 19 (3)

Historical context of dopaminergic agonists

Estrada-Bellmann I, Cámara-Lemarroy C, Delgado-García G, Cerda-Contreras C

Language: Spanish
References: 69
Page: 74-84
PDF size: 163.50 Kb.


ABSTRACT

Introduction: Shortly after the introduction of levodopa in the therapeutics of Parkinson's disease (PD), it became clear that its chronic use was associated with some adverse effects. Considering that dopamine agonists (DAs) act directly on the nigrostriatal system and that their half-lives are longer, it was hypothesized that using them could prevent these adverse effects.
Objective: To conduct a narrative review about the historical development of DAs.
Results: Even though DAs have been used in the treatment of PD only since the seventies, there were already reports on the effects of apomorphine at the beginning of the last century. The search for drugs that modulate prolactin led to the discovery of bromocriptine, a DA derived from ergocryptine, in the 1960s. Its effectiveness in PD was established in the following decade. In the last two decades of the last century there was a marked advance in the development of non-ergotamine DAs (e.g., ropinirole, pramipexole and rotigotine). Currently the use of these is increasing due to its more favorable profile. However, these DAs are associated with other adverse effects.
Conclusions: As monotherapy, non-ergotamine DAs are a safe alternative in early PD and in young patients. However, they are usually administered together with levodopa in advanced PD. The development of new DAs continues and this has allowed to deepen our knowledge on dopaminergic receptors, thus enabling the creation of more selective and specific drugs.


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