Posted by sukarno on May 3, 2005, at 23:34:03
In reply to Re: Dopamine agonist (Mirapex) + DRI (Survector) » pro_social_soon, posted by Chairman_MAO on May 3, 2005, at 19:13:20
Skip all of those and try Trivastal (piribedil):
http://www.servier.com/pro/Neurosciences/trivastal/trivastal_press.asp
When you click that link it will take you to their cardiovascular page, so click on "Neurosciences" and then "Trivastal".
It boosts dopamine D2 and D3 and also norepinephrine. It is also a non-ergot. This might be better than Survector...well, hard to imagine that, but just might be. Sounds like it does the same thing.
You can't abuse this one because they designed it so that you'll vomit if you reach a high dose.
:)
Summary of Product CharacteristicsComposition:
Piribedil 50 mg per tablet - sustained-release.
Indications:
- Treatment of Parkinson's disease, either as monotherapy (without L-dopa) or in combination with L-dopa therapy, in the early stages as well as in the advanced stages.
- Treatment of pathological cognitive deficits in the elderly (impaired attention, memory, etc). Treatment of dizziness in the elderly.
- Treatment of Retinal ischemic manifestations. Adjuvant treatment in intermittent claudication due to peripheral occlusive arterial disease of the lower limbs (stage 2).
Dosage
In Parkinson's disease: administration of Trivastal retard 50 should be initiated with 1 tablet daily during the first week. Dosage should then be gradually increased every week until achieving the optimal therapeutic dose: as monotherapy: 3 to 5 tablets in 3 to 5 divided doses daily. In combination with L-dopa therapy:
1 to 3 tablets daily. In other indications: 1 tablet daily at the end of the main meal. In severe cases: 2 tablets daily as 2 divided doses.Trivastal retard 50 is a nonergot dopamine agonist, selective for D2 and D3 dopamine receptors subtypes at the cerebral and at the peripheral level.
Cardiogenic shock. Acute phase of myocardial infarction.
Adverse
rare side effects: minor gastrointestinal disorders (nausea, vomiting, flatulence) in predisposed individuals, or when taken between meals. They may resolve with the following: individual dosage adjustment, and/or addition of domperidone. Orthostatic hypotension or drowsiness may occur, particularly in predisposed individuals (underlying condition or causative illness).
Dopaminergic antagonists.
Overdosage:
At very high doses, Trivastal retard 50 has an emetic action on the CTZ (chemoreceptive trigger zone). Tablets will thus be rapidly rejected, which explains why no data are currently available concerning the risk of overdosage.
Product Description
TRIVASTAL RETARD 50: a reference dopamine agonist for Parkinson's disease treatmentTrivastal Retard 50 is a selective D2/D3 dopamine receptor agonist with additional α2-noradrenergic properties, effective in two major pathologies: Parkinson's disease and cerebral aging.
In Parkinson's disease, Trivastal Retard 50 offers a wider range of benefits at all stages of the disease, thanks to the combination of three major pharmacological features:
unique D2/D3 agonistic α2-noradrenergic properties1
stable plasma levels over 24 hours2
a long half-life elimination time (21 hours)3By correcting the dopamine deficit of the postsynaptic D2 receptors of the nigrostriatal pathway, Trivastal Retard 50 offers powerful efficacy in monotherapy, on the three major signs of Parkinson's disease, rigidity, bradykinesia, and tremor, with less dyskinesia than levodopa.4,5 Trivastal Retard 50 is also an effective treatment in adjunct to levodopa at all stages of Parkinson's disease, on the major signs, with a dramatic impact on tremor.6-10 Moreover, in patients already established with levodopa, Trivastal Retard 50 reverses dyskinesia induced by the levodopa treatment while maintening similar efficacy on cardinal motor symptoms.11 Thanks to its additional presynaptic α2-adrenoreceptor antagonism property, Trivastal Retard 50 enhances central noradrenergic neurotransmission and widens its antiparkinsonian efficacy to symptoms that resist levodopa treatment, such as postural instability and gait disorders.12
Furthermore, Trivastal Retard 50 is generally well- tolerated in monotherapy, as well as in combination with levodopa4-8 and causes an increase in vigilance and alertness which may be related to its α2-noradrenergic properties.13,14
Concerning Trivastal Retard 50 in monotherapy, patients can be titrated to an effective dosage of 3 to 5 tablets a day within 3 to 7 weeks. In combination with levodopa, a dosage of 1 to 3 tablets a day can be achieved in 1 to 3 weeks. The initiation of Trivastal Retard 50 is therefore both shorter and simpler than for other dopamine agonists used in Parkinson's disease.15
In cerebral aging, by correcting the dopamine deficit of the postsynaptic D2/D3 receptors of the mesocortical and mesolimbic pathways, Trivastal Retard 50 provides effective treatment for cognitive disorders in the elderly. Indeed, Trivastal Retard 50, compared with placebo and reference cerebral vasodilators, leads to significant improvement of disorders which make up the clinical picture of cerebral dopamine deficiency: attention, concentration, and memory, as well as mood disorders.15,16Trivastal Retard 50 has demonstrated a significant global cognitive improvement (Mini-Mental State) versus placebo in patients with aged related cognitive decline.17 Furthermore, Trivastal Retard 50's additional α2-noradrenergic property reinforces its positive impact on cognitive and motor functions.18,19
By reinforcing noradrenergic transmission, Trivastal Retard 50 may prevent distractibility by irrelevant stimuli.18,19
Signals are better perceived and better understood by patients, who are thus more attentive and intellectually alert, with a dose only 1 tablet once a day, and 2 tablets in severe cases.
In Practice
Trivastal retard 50: In Practice
Trivastal retard 50 has a unique pharmacological profile: D2/D3 agonist and α2 antagonist.
- is a non-ergot dopamine agonist.
Trivastal retard 50 has a powerful efficacy in all motor symptoms.- can be prescribed in monotherapy and in combination to Levodopa.
- can be prescribed for patients in early stage of Parkinson disease as in late stage of the disease.
- has a powerful L-dopa sparing effect.
- has an efficacy which cover the 24-hour period and reinforce the continuous dopaminergic stimulation.
Trivastal retard 50 is effective on cognitive disorders (vigilance, memory, attention, …).- is effective on posture and gait disorders.
- induces less dyskinesia than L-dopa.
Trivastal retard 50 is effective on disorders of attention and concentration in the elderly with cerebral aging.- in cerebral aging its 1 tablet per day, 1 box per month, for at least 3 months.
Trivastal retard 50 in Parkinson’s disease has also an ease-of-use :1 to 5 tablets a day in monotherapy and 1 to 3 tablets a day in combination with Levodopa.
As prescribing information may vary from country to country, please refer to the complete data sheet supplied in your country.
Les Laboratoires Servier France.
Correspondent: Servier International - 22, rue Garnier - 92200 Neuilly sur Seine - France.
poster:sukarno
thread:492562
URL: http://www.dr-bob.org/babble/20050428/msgs/493449.html