The role of subcutaneous infusion of apomorphine in Parkinson's disease

Karoline Wenzel, Carl Nikolaus Homann, Giovanni Fabbrini, Carlo Colosimo

Research output: Contribution to journalArticle

Abstract

Continuous subcutaneous apomorphine infusion therapy (CSAI) has proved to be effective in advanced Parkinson's Disease patients with motor fluctuations not controlled by oral or transdermal medication. In this clinical setting it competes directly with intrajejunal levodopa and deep brain stimulation (DBS), however randomised controlled comparative studies are lacking. The advantages of CSAI is that it is the least invasive of these three therapeutic options, is reversible, practical to use and has shown significant efficacy for the management of both peak-effect dyskinesias and off-period nonmotor-symptoms. Contraindications to the use of CSAI are severe dementia or neuropsychiatric symptoms and severe biphasic dyskinesias, however unlike DBS, advanced age is not a contraindication. This review summarises the evidence regarding efficacy, safety and tolerability of CSAI, provides guidance on the selection of suitable patients and gives practical instructions on how to initiate CSAI and manage possible adverse events.

Original languageEnglish
Pages (from-to)833-843
Number of pages11
JournalExpert Review of Neurotherapeutics
Volume14
Issue number7
DOIs
Publication statusPublished - 2014

Keywords

  • apomorphine
  • dyskinesias
  • levodopa-induced fluctuations
  • Parkinson's disease
  • subcutaneous infusion

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)
  • Pharmacology (medical)
  • Medicine(all)

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