LA CABERGOLINA EN EL TRATAMIENTO DE LA ENFERMEDAD DE PARKINSON

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La cabergolina es una opción adecuada para los pacientes con enfermedad de Parkinson de novo.
pastormu9.jpg Autor:
Pau Pastor munoz
Columnista Experto de SIIC

Institución:
Department of Psychiatry and Genetics Washington University School of Medicine


Artículos publicados por Pau Pastor munoz
Coautor
Eduardo Tolosa* 
Unidad de Parkinson y Movimientos Anormales. Servicio de Neurología, Institut Clínic de Malalties del Sistema Nerviós, IDIBAPS. Hospital Clínic, Facultad de Medicina de la Universidad de Barcelona, Ba*
Recepción del artículo
11 de Enero, 2005
Aprobación
22 de Febrero, 2005
Primera edición
13 de Septiembre, 2005
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
La cabergolina (1-[(6-alelilergolin-8 beta-il)carbonil]-1-[3-(dimetilamino)propil]-3-etilurea) es un novedoso agonista de los receptores dopaminérgicos D2 para la terapia farmacológica en la enfermedad de Parkinson (EP). La cabergolina tiene una vida media larga (alrededor de 68 horas) lo que permite su administración en dosis única diaria. En base a la información disponible en monoterapia, la cabergolina induce una mejoría de los síntomas similar al proporcionado por otros agonistas dopaminérgicos. En pacientes con EP de novo, la cabergolina en monoterapia representa una opción adecuada para el tratamiento sintomático ya que mejora los síntomas motores, retrasa la aparición de complicaciones motoras por levoterapia y disminuye los requerimientos de levodopa. Como tratamiento coadyuvante a la levodopa es un fármaco apropiado debido a que mejora la función motora, reduce la intensidad y duración de los periodos off y reduce los requerimientos de levodopa. Estudios preliminares sugieren que la cabergolina es eficaz en el tratamiento de la acinesia y la distonía nocturna en la EP avanzada. La cabergolina es bien tolerada. Los efectos colaterales se producen principalmente a nivel del sistema nervioso central y del aparato digestivo. La eficacia de la cabergolina con respecto a otros agonistas dopaminérgicos en el control de los síntomas de la EP debe ser analizada en futuros estudios.

Palabras clave
Cabergolina, enfermedad de Parkinson, agonistas dopaminérgicos


Artículo completo

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Abstract
Cabergoline (1-[(6-allelylergolin-8 beta-yl)carbonyl]-1-[3-(dimethylamino)propyl]-3-ethyl-urea) is a new agonist of the D2 dopaminergic receptors used in the treatment of Parkinson’s disease. Cabergoline is characterized by unique pharmacologic properties, such as its long plasma half-life (about 68 hours), which allows for once a day administration. Cabergoline is well tolerated, as has been shown in several clinical trials. Based on the information available, we suggest that cabergoline produces an improvement in the symptoms of Parkinson disease similar to those produced by other dopaminergic agonists. Cabergoline monotherapy, when used in previously untreated patients, is an appropriate option for the symptomatic treatment of Parkinson disease. Cabergoline improves motor symptoms, delays the presentation of levodopa-induced motor complications, and diminishes the amount of levodopa required for the control of the symptoms. We suggest that cabergoline is an adequate adjuvant treatment for Parkinson disease. There is improvement in motor symptoms (without substantially increased dyskinesias), reduced severity and duration of the wearing-off period, and diminished need for levodopa. Cabergoline can also be useful in the treatment of sleep disturbances associated with advanced Parkinson disease such as nocturnal akynesia and dystonia. However, additional studies on cabergoline’s effects in nocturnal disturbances associated with Parkinson disease are still required. Cabergoline is a well tolerated drug. Its side effects are seen mainly in the digestive and nervous system (central and peripheral). The efficacy of cabergoline in comparison to other dopaminergic agonists should be tested in future clinical studies.

Key words
Cabergoline, Parkinson disease, dopaminergic agonists


Clasificación en siicsalud
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Especialidades
Principal: Neurología
Relacionadas: Farmacología, Medicina Farmacéutica, Medicina Interna



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