Many of the RLS patients do show at least minor initial clinical betterment from dopaminergic drugs or alpha 2 delta ligands, such as levodopa,
dopamine agonists or Pregabalin.
Dopamine agonist therapy in early Parkinson's disease.
Bromocriptine is the next
dopamine agonist after cabergoline which evokes interest in recent years, owing to its advantages in patients at risk of OHSS, including its shorter half-life and greater experience with this drug in pregnancy, the lack of teratogenicity, despite side effects such as nausea, headaches and orthostatic dysregulation.
Notably,
dopamine agonists accounted for 62.43% of expenditures on antiparkinsonian medicine.
Asymptomatic patients harboring microprolactinomas do not need to be prescribed
dopamine agonists.3 Symptomatic prolactin-secreting microadenomas may be treated with bromocriptine or cabergoline before pregnancy, to lower prolactin levels, decrease tumour size, and restore gonadal function.
Therefore, bromocriptine, a
dopamine agonist, has been proposed as a treatment option.
Multiple agents including
dopamine agonists such as carbidopa/levadopa, ropinirole, and pramipexole as well as gabapentin, clonazepam, and opioids have been used in the management of RLS symptoms.
Dopamine agonists are medications that activate signaling pathways between brain cells using the cells' own dopamine receptors when there is an absence or reduction of dopamine in the brain.
However a problem with the above theory is that in some people with RLS,
dopamine agonists actually make their symptoms worse.
Anyone receiving treatment with a
dopamine agonist, or caring for someone receiving this treatment, who notices unusual behaviours, such as new or increased gambling urges, increased sexual urges or other intense urges should talk to their doctor."
The company has also received feedback about the findings of the studies showing statistically significant efficacy of safinamide as add-on therapy in patients receiving a stable dose of a single
dopamine agonist in early PD patients and on motor fluctuations in patients with advanced PD on levodopa and other PD treatments.