Tags

Type your tag names separated by a space and hit enter

Effects of gabapentin on the motor response to levodopa: a double-blind, placebo-controlled, crossover study in patients with complicated Parkinson disease.
Clin Neuropharmacol 2004 May-Jun; 27(3):124-8CN

Abstract

BACKGROUND

Motor fluctuations and dyskinesias affect many parkinsonian patients chronically treated with levodopa. Imbalance between gabaergic direct and indirect striatopallidal pathways may originate them. Manipulating GABA neurotransmission may be effective in the treatment of these patients. Gabapentin is an antiepileptic drug that increases the synthesis and release of GABA. Previous studies suggest that gabapentin may be useful in Parkinson disease (PD).

OBJECTIVE

To know the effects of gabapentin on the motor response to levodopa in PD patients with motor complications.

DESIGN

A randomized double-blind, placebo-controlled, cross-over trial with four weeks of treatment.

SETTING

A tertiary referral center.

PARTICIPANTS

Twenty subjects with PD and motor fluctuations and dyskinesias on stable antiparkinsonian treatment, took gabapentin up to a maximum dose of 2.400 mg/d in three doses and placebo.

METHODS

Three levodopa challenges were performed: at the beginning of the study and at the end of each period of treatment (4 weeks). Basal (off) and best (on) motor status were assessed by the UPDRS III. Latency to peak effect, magnitude of motor response (difference between "on" and "off" scores in the UPDRS III), duration of motor response and severity and duration of dyskinesias after each levodopa challenge were assessed. Patients' diaries were administered.

RESULTS

: Fifteen patients completed the study. A significant improvement in the basal UPDRS III resulting in a significant reduction in the magnitude of the motor response after gabapentin was obtained (P < 0.001). No other changes were observed, either on pharmacological parameters or in levodopa-induced dyskinesias. Number of daily hours spent in "on," "on with dyskinesias" and "off" also remained unchanged. Tolerance was good, dizziness being the most common side effect.

CONCLUSION

Gabapentin improved parkinsonian symptoms (basal UPDRS III and magnitude of the motor response) following levodopa. This improvement was not reflected in the daily motor situation of patients. Dyskinesias remained unchanged. Gabapentin was well tolerated. Further studies are needed to know the impact of these results in the long-term.

Authors+Show Affiliations

Centro de Neurología y Neurocirugía funcional, Clínica Quirón, San Sebastián, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15190235

Citation

Van Blercom, N, et al. "Effects of Gabapentin On the Motor Response to Levodopa: a Double-blind, Placebo-controlled, Crossover Study in Patients With Complicated Parkinson Disease." Clinical Neuropharmacology, vol. 27, no. 3, 2004, pp. 124-8.
Van Blercom N, Lasa A, Verger K, et al. Effects of gabapentin on the motor response to levodopa: a double-blind, placebo-controlled, crossover study in patients with complicated Parkinson disease. Clin Neuropharmacol. 2004;27(3):124-8.
Van Blercom, N., Lasa, A., Verger, K., Masramón, X., Sastre, V. M., & Linazasoro, G. (2004). Effects of gabapentin on the motor response to levodopa: a double-blind, placebo-controlled, crossover study in patients with complicated Parkinson disease. Clinical Neuropharmacology, 27(3), pp. 124-8.
Van Blercom N, et al. Effects of Gabapentin On the Motor Response to Levodopa: a Double-blind, Placebo-controlled, Crossover Study in Patients With Complicated Parkinson Disease. Clin Neuropharmacol. 2004;27(3):124-8. PubMed PMID: 15190235.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of gabapentin on the motor response to levodopa: a double-blind, placebo-controlled, crossover study in patients with complicated Parkinson disease. AU - Van Blercom,N, AU - Lasa,A, AU - Verger,K, AU - Masramón,X, AU - Sastre,V M, AU - Linazasoro,G, PY - 2004/6/11/pubmed PY - 2004/9/28/medline PY - 2004/6/11/entrez SP - 124 EP - 8 JF - Clinical neuropharmacology JO - Clin Neuropharmacol VL - 27 IS - 3 N2 - BACKGROUND: Motor fluctuations and dyskinesias affect many parkinsonian patients chronically treated with levodopa. Imbalance between gabaergic direct and indirect striatopallidal pathways may originate them. Manipulating GABA neurotransmission may be effective in the treatment of these patients. Gabapentin is an antiepileptic drug that increases the synthesis and release of GABA. Previous studies suggest that gabapentin may be useful in Parkinson disease (PD). OBJECTIVE: To know the effects of gabapentin on the motor response to levodopa in PD patients with motor complications. DESIGN: A randomized double-blind, placebo-controlled, cross-over trial with four weeks of treatment. SETTING: A tertiary referral center. PARTICIPANTS: Twenty subjects with PD and motor fluctuations and dyskinesias on stable antiparkinsonian treatment, took gabapentin up to a maximum dose of 2.400 mg/d in three doses and placebo. METHODS: Three levodopa challenges were performed: at the beginning of the study and at the end of each period of treatment (4 weeks). Basal (off) and best (on) motor status were assessed by the UPDRS III. Latency to peak effect, magnitude of motor response (difference between "on" and "off" scores in the UPDRS III), duration of motor response and severity and duration of dyskinesias after each levodopa challenge were assessed. Patients' diaries were administered. RESULTS: : Fifteen patients completed the study. A significant improvement in the basal UPDRS III resulting in a significant reduction in the magnitude of the motor response after gabapentin was obtained (P < 0.001). No other changes were observed, either on pharmacological parameters or in levodopa-induced dyskinesias. Number of daily hours spent in "on," "on with dyskinesias" and "off" also remained unchanged. Tolerance was good, dizziness being the most common side effect. CONCLUSION: Gabapentin improved parkinsonian symptoms (basal UPDRS III and magnitude of the motor response) following levodopa. This improvement was not reflected in the daily motor situation of patients. Dyskinesias remained unchanged. Gabapentin was well tolerated. Further studies are needed to know the impact of these results in the long-term. SN - 0362-5664 UR - https://www.unboundmedicine.com/medline/citation/15190235/Effects_of_gabapentin_on_the_motor_response_to_levodopa:_a_double_blind_placebo_controlled_crossover_study_in_patients_with_complicated_Parkinson_disease_ L2 - http://dx.doi.org/10.1097/00002826-200405000-00007 DB - PRIME DP - Unbound Medicine ER -