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Pergolide, a dopamine receptor agonist, given daily i.p. for three weeks at 0.04 mg/kg and 0.4 mg/kg, significantly induced soluble (Cu-Zn) superoxide dismutase in the rat striatum, while having no effect on the mitochondrial (Mn) form of the enzyme. Such induction, which can also be effected by (-)-deprenyl, may help to protect against nigrostriatal degeneration.
Lesion of the nigrostriatal dopaminergic pathway in the rat by 6-hydroxydopamine enhances the ability of pergolide to increase striatal acetylcholine levels and prevents the haloperidol-induced decrease in acetylcholine concentrations. This supersensitive response of striatal cholinergic cells is already maximal 6 days after lesion but tends to decrease thereafter. As the time course of the development of the supersensitivity of cholinergic cells differs from that of increased dopamine binding site density, the two are probably not causally related, the former reflecting rather a change occurring beyond the dopamine recognition site.
Rat superfused striatal slices, preloaded with [3H]dopamine, were electrically stimulated and the stimulation-induced outflow of radioactivity was taken as an index of dopamine release. In the presence of 10 microM nomifensine, exposure of striatal slices to unlabelled dopamine (0.3 microM) for 6 min prior to stimulation, significantly reduced stimulation-induced outflow. In contrast, a 21-min exposure to dopamine did not significantly alter stimulation-induced outflow. These results suggest that D2 receptors modulating dopamine release in the rat striatum may be rapidly desensitized in vitro. Rats were pretreated for 14 days with cocaine HCl (10 mg/kg/day i.p.) or saline. A progressive enhancement of locomotor activity in cocaine-treated rats over the pretreatment period compared to that in saline-treated rats indicated a behavioural sensitization to cocaine. The inhibitory effect of pergolide (1, 10 and 100 nM) on stimulation-induced outflow from striatal slices obtained from cocaine-pretreated rats was not different from that in slices obtained from saline-pretreated rats. Therefore no evidence was obtained for either a desensitization or a supersensitivity of striatal D2 autoreceptors by chronic cocaine administration.
Considerable evidence indicates that cholinomimetic-induced tremulous jaw movements in rats share many characteristics with human Parkinsonian tremor, and several antiparkinsonian drugs suppress cholinomimetic-induced tremulous jaw movements. The present study investigated three different types of dopamine agonists, which have known antiparkinsonian characteristics, for their ability to suppress the tremulous jaw movements induced by tacrine (5.0 mg/kg). The non-selective dopamine agonist pergolide, a widely used antiparkinsonian drug, was highly potent at suppressing tacrine-induced jaw movements (e.g. 0.125-1.0 mg/kg). The selective D2 agonist ropinirole, which also is used clinically as an antiparkinsonian drug, suppressed jaw movements in the dose range of 2.5-20.0 mg/kg. The D1 agonist CY 208-243, which has been reported to suppress tremor, also reduced jaw movement activity (4.0 mg/kg). Across several studies, the rank order of potency for suppressing cholinomimetic-induced jaw movements in rats is related to the potency for producing antiparkinsonian effects in humans. Together with previous studies, the present results suggest that cholinomimetic-induced jaw movements in rats can be used to characterize dopaminergic antiparkinsonian agents and to investigate the basal ganglia circuits involved in the generation of tremulous movements.
Pergolide (PG) a semi-synthetic ergot alkaloid derivative used mainly for the treatment of Parkinson's disease is known to be a photosensitive drug substance. The major photodegradation products are PG sulphoxide (SX) and PG sulphone (SN), which are also the main impurities of the bulk drug substance. It is widely metabolized to more than 10 metabolites including SX and SN. In this work an improved photostability indicating ion-pair chromatography method for PG mesilate was developed. The method can be applied in the determination of PG and impurities in aqueous solutions and in tablets for routine analysis. This new method is appropriate for the quantitative determination of PG in the presence of its impurities and photodegradation products and can also be used for PG complexes with cyclodextrins (commonly used as photostabilizing agents). Furthermore it is suitable for the quantitation of its impurities and its thermal or photo-induced decomposition products. Separation was achieved on a ThermoQuest C(18) BDS column and Sodium octanosulphonate was used as ion-pairing agent. Analysis was performed at 223 nm. Validation parameters included: specificity, linearity, precision and accuracy, limit of quantitation and suitability. The method was found to be specific and linear for PG, as well as for SX and, SN impurities. The recovery was 100.83+/-0.46% for PG, 99.86+/-0.33% for SX and 99.77+/-1.84% for SN. Finally the photodegradation profile of PG mesilate was studied in different initial sample concentration. The obtained result revealed that: PG photolysis is catalyzed by its degradation products and that decrease of initial sample concentration reduces the rate of PG photoinduced degradation.
An 8-month multicentre prospective randomized study aimed at comparing the effects of dopamine receptor agonists pramipexole (PPX; Mirapexin) and pergolide (PRG; Permax) as add-on to L-dopa therapy on depression [Montgomery and Asberg Depression Rating Scale (MADRS)] in 41 non-demented patients (25 men, 16 women) suffering from both mild or moderate depression and advanced Parkinson's disease (PD). The assessment was performed by a blinded independent observer. Motor symptoms (UPDRS III), motor complications (UPDRS IV), activities of daily living (UPDRS II and VI) and depressive symptoms as measured by Self - Rating Depression Scale by Zung were evaluated in an open-label design. The average value of Zung scores decreased significantly in both groups with no statistical difference between both groups. A significant decrease in the average value of MADRS scores was present only in the PPX group. The average UPDRS scores decreased significantly with no statistical difference between both groups at the comparable average total daily dose of both preparations. In both cases, the total daily dose of L-dopa decreased significantly but the decrease was statistically more pronounced in the PRG group. Our results demonstrate the antidepressant effect of PPX in patients with PD while we can't make any conclusions with regard to antidepressant effect of PRG.
Pleuropulmonary fibrosis is a rare, but well-recognized adverse effect of ergot alkaloids. We report on four patients who developed pleural and/or pulmonary fibrosis during treatment with pergolide and give characteristics of 87 cases with one or more symptoms of serosal fibrosis. Retroperitoneal and pleuropulmonary fibrosis are serious conditions, which are often irreversible after drug withdrawal. Increased awareness may help to diagnose these complications at an earlier stage and to minimize any permanent damage to the patient.
Animal models in behavioral pharmacology can be evaluated based on their face, predictive and construct validity. A further level of validity may be achieved if a model is reproduced precisely across species--from laboratory animal to human--using identical conditions and manipulations to elicit identical behavioral changes. Under circumstances in which a model achieves 'homologous' validity, it should be possible to demonstrate that the same pharmacological agents produce parallel changes in the same behavior (as distinct from the clinical condition that the animal behaviors are hypothesized to model), when studied in laboratory animals and in humans. Studies have demonstrated that the disruption of sensorimotor gating of the startle reflex, measured by prepulse inhibition (PPI), in rats by dopamine agonists exhibits face, predictive and construct validity for the relative loss of PPI in schizophrenia patients. To assess the homologous validity of this model, and to expand its utility in understanding the pathophysiology of sensorimotor gating deficits and in developing novel antipsychotic agents to reverse these deficits, it will be important to study PPI across species, comparing response profiles to identical pharmacological manipulations. In the present studies, we report that PPI in rats is reduced in a dose-dependent manner by four dopamine agonists that can be administered with relative ease to humans. We also report that the PPI-disruptive effects of the clinically useful dopamine agonist pergolide are reversed by both typical and atypical antipsychotics. These studies establish a foundation for pursuing human pharmacological studies of PPI, and for extrapolating the substantial neurochemical and neurophysiological information from animal studies of PPI, towards understanding the neural basis for deficient sensorimotor gating in specific neuropsychiatric disorders.
The aim of this study was to compare patients with Parkinson disease (PD) patients treated with pergolide mesylate (PM), a dopaminergic receptor agonist, together with L-DOPA and those these treated with L-DOPA alone on the concentration of free radicals (FR), glutathione, and the activity of superoxide dismutase (SOD) and catalase in the serum. The study was carried out using 16 age-matched control subjects, 16 PD patients treated with L-DOPA at a dose of 1 to 1.5 g daily, and 16 PD patients treated with L-DOPA 1 to 1.5 g daily with PM 0.75 to 1.25 mg daily. The mean duration of treatment of PD was 6 years (range, 2-8 years) with l-DOPA, and 2 years with PM + L-DOPA or L-DOPA alone. Although there was no significant difference in lipid peroxidation products among the 3 groups, patients treated with L-DOPA showed high levels of FR as determined by dichlorofluorescein. Although catalase and SOD activities were elevated in both groups of PD patients, additional treatment with PM further enhanced catalase activity compared with those treated with l-DOPA alone. Interestingly, patients treated with PM + L-DOPA showed a significantly increased level of glutathione compared with those treated with L-DOPA alone. Collectively, these data suggest that PM + L-DOPA is a more efficient therapy in maintaining an antioxidative defense in PD patients compared with treatment with L-DOPA alone.
Constrictive pericarditis is present when a fibrotic, thickened, and adherent pericardium restricts diastolic filling of the heart. Several drugs can cause pericarditis, which can lead to chronic pericardial constriction. A case of constrictive pericarditis in a patient receiving the antiparkinsonian drug pergolide is reported.
A 16-year-old, male, Hanoverian horse had a three-month history of weight loss, hirsutism and polyuria/polydypsia. Examinations revealed neutrophilia, lymphopenia, hyper glycaemia and abnormalities in hepatic function. A tentative diagnosis of hyperadrenocorticism was made. The results of thyroid-releasing hormone and combined dexamethasone suppression and ACTH stimulation tests suggested the presence of a pituitary adenoma. The horse was treated with pergolide and beneficial clinical and biochemical responses were observed within one to six months.
A patient with severe Parkinson's disease presented with increasing dyspnea, bilateral pleural effusion and peripheral edema that were refractory to diuretic therapy and were first misdiagnosed as signs of right-sided heart failure. Pergolide was the only culprit for this devastating condition and on its discontinuation all signs of fluid retention resolved. In this report, drug reactions to ergots and dopamine agonists are discussed.
Parkinson's disease, because of its progressive degenerative nature, is associated with increased disability and mortality compared with mortality in the general population. We examined mortality data from three clinical trials involving 1,330 patients with Parkinson's disease treated with pergolide as an adjunct to levodopa or levodopa/carbidopa therapy. The ratio of observed deaths to expected deaths in the general population of the same age, gender, race distribution, and period of observation was 2.3 for the 3 studies combined. The ratio is lower than that in Parkinson's disease patients treated prior to the introduction of levodopa, consistent with ratios with levodopa and levodopa combination therapy. The ratio is slightly higher than in Parkinson's disease patients treated with levodopa and levodopa combination therapy, which may be attributable to differing patient characteristics in the populations studied.
Refractory response to dopamine (DA) agonists is a common problem in the treatment of Parkinson's disease. In rats with unilateral lesions of the substantia nigra, denervation induced significant increases in striatal 3(H)-spiperone binding sites ipsilateral to the lesion. Chronic treatment with levodopa or with pergolide mesylate significantly decreased the number of 3(H)-spiperone striatal binding sites. Agonist-induced decreases were approximately equivalent in intact and denervated striata and did not appear to be affected by lesions. These results suggest that the poor response to DA agonist in certain parkinsonian patients with chronic drug exposure may be mediated by drug-induced DA receptor down-regulation.
Retroperitoneal fibrosis is a rare complication of pergolide therapy. This complication can be easily missed, so it is essential to have a high index of suspicion. We describe a case of well controlled Parkinson's disease who presented with shortness of breath and oedema.
The aim of our study was to investigate serum cGMP level in patients treated with L-DOPA alone and L-DOPA with pergolide mesylate (PM) and to compare the obtained values with age-matched healthy subjects. PD patients treated with L-DOPA or with PM + L-DOPA had significantly higher cGMP levels in serum as compared to control. Moreover, cGMP level was significantly higher after treatment with PM + L-DOPA then L-DOPA alone. We did not observed significant differences in UPDRS scores between both PD groups. Our data suggest that changes in serum cGMP level in PD patients are related with PM + L-DOPA or L-DOPA alone therapy.
The acute effects of a single 10 micrograms dose of a new dopamine agonist, pergolide, were investigated in 6 healthy women and 6 women with cyclical oedema. There was a prompt and significant reduction in mean plasma prolactin concentrations with maximum suppression occurring at 4 hours in both groups. However, the prolactin suppression was significantly less in the women with cyclical oedema. This is further evidence for a prolactin disturbance in cyclical oedema, and consistent with the proposal that reduced dopaminergic tone may be an important abnormality in the disorder.
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