Bromocriptine, lysuride (formerly lisuride, Revanil – Roche) and pergolide (not yet marketed in the UK) are dopamine agonists developed for use in the treatment of patients with Parkinson’s disease. Combination of a dopamine agonist with levodopa plus a dopa-decarboxylase inhibitor (‘co-dieldopa’)* may have advantages at all stages of the disease. The aim of combined co-dieldopa + agonist treatment is to limit some of the problems with prolonged co-dieldopa use alone; especially fluctuations in motor disability.1 It is still not clear how the three agonists compare with each other for therapeutic efficacy, duration of action, and side effects, nor how they are best combined with co-dieldopa.
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↵* fixed dose combination preparations of leveodopa plus the dopa-decarboxylase inhibitor benserazide (Madopar) now have the generic name co-beneldopa; those for levodopa plus carbidopa (Sinemet) co-careldopa. In this article we refer to both as ‘co-dieldopa’.