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Parlodel is derived from “ergot,” and has several uses. Here we discuss its use for Parkinson’s disease, for which it is the second-choice drug, after a combination of levodopa and carbidopa (SINEMET, SINEMET CR). If you have Parkinson’s disease, your doctor should first try levodopa with carbidopa and should prescribe Parlodel only if the combination drug does not decrease your symptoms or if it causes too many adverse effects. Parlodel often works best when given with levodopa. If you are over 60, you should generally be taking less than the usual adult dose.
In older adults, Parlodel often causes dizziness, nausea, constipation, and tingling in fingers or toes when exposed to the cold. It can also cause more serious adverse effects called choreiform movements—unusual and uncontrolled movements in the body, face, tongue, arms, hands, and upper body. About 25% of Parlodel users in all age groups experience this adverse effect. If you have any of these symptoms, especially if they are severe or persistent, call your doctor and ask if your dose of Parlodel should be reduced. Do not take less Parlodel than your doctor prescribed unless he or she instructs you to do so.
In 2005, the FDA revised the product package insert of Parlodel (Bromocriptine) regarding post marketing safety data relating to sudden onset of sleep and possible problems involving the membranes that line and surround the heart and lungs.
Physicians from the Mayo Clinic in Rochester, Minn., publishing in the September 2005 Archives of Neurology, examined the relationship between the drugs used to treat Parkinson’s disease known as dopamine agonists and pathological gambling. The dopamine agonist group of drugs includes Parlodel (Bromocriptine), pergolide (PERMAX), pramipexole (MIRAPEX), and ropinirole (REQUIP).
The Mayo Clinic physicians identified 11 patients between 2002 and 2004 who met the definition of pathologic
gamblers. All had Parkinson’s disease, and all were being treated with levodopa and a dopamine agonist. The Mayo Clinic physicians also searched the world’s medical literature for other reports of pathological gambling associated with the use of dopamine agonists. They found six published reports involving an additional 17 patients. The authors commented that “The relationship of pathological gambling to dopamine agonist therapy in these cases is striking.”
If you have symptoms of parkinsonism (tremor, rigid muscles, and disturbances in posture, walking, balance, speech, swallowing, and muscle strength), there is a good chance that they are caused by a drug you are taking. As many as half of older adults with symptoms of parkinsonism may have developed them as adverse effects of a drug. If you take any of the drugs on this list, discuss the possibility of drug-induced parkinsonism with your doctor and ask to have your prescription changed or stopped.