(Brand names in India: Pramipex, Pramipex ER, Ropark, Ropark XL)
How do dopamine agonists work?
These chemicals are imitators.
They look just like Dopamine itself. They attach themselves to the same sites that Dopamine usually attaches itself. Therefore, they produce similar effects in the brain as Dopamine and relieve the symptoms of Parkinson’s disease.
Pramipexole (and Ropinirole) looks like Dopamine.
Use/Advantages:
“Extended-release” / 24-hour preparations: The effect of a single tablet of “Extended Release” Pramipexole (or Ropinirole) can last for 24 hours.
The main advantage is that these medications have “extended-release preparations” that gradually dissolve in the stomach so that they keep gradually entering the blood and then the brain for the entire day. Therefore the effects of a single tablet taken in the morning can last for 24 hours. This infrequent dosing is very convenient! But even more importantly in patients who have Predictable-wearing-OFF or other motor fluctuations with levodopa, these long-acting medications can maintain good movement throughout the day, to “smoothen out the day”.
They may produce less dyskinesias than levodopa. They may therefore be used to start treatment in younger patients (e.g. below 45) or may be added to the treatment of a person who cannot tolerate high doses of levodopa due to dyskinesias.
Disadvantages:
These medications are not as strong as levodopa. When given in smaller doses, they may not relieve all the symptoms of Parkinson’s disease.
When given in higher doses, they can produce troublesome side-effects including excessive daytime sleepiness, impulse control problems such as gambling and rarely, sleep disturbances & hallucinations. In particular, the excessive sleepiness during the day often limits their use – restricting their use to smaller doses.Rarely, dopamine Imitators can cause Impulse Control Disorders including gambling, excessive spending or excessive eating. But the most common side-effect is sleepiness.
Bottom-line:
While good in theory, it is difficult to use these medications in practice. They are sometimes used for the treatment of very young patients with Parkinson’s disease. Also, the fact that 24 hour preparations are available make these medications useful in certain niche situations such as predictable-wearing OFF.
Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor's permission.
Dr. Siddharth Kharkar
Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine. He is a board certified (American Board of Psychiatry & Neurology certified) Neurologist.
Dr. Siddharth Kharkar is a Epilepsy specialist in Mumbai & Parkinson's specialist in Mumbai, Maharashtra, India.
He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.
Out patient is epileptic from about 10 years and her seizure gotten worse during the past year with the frequency of about 3-4 times a week.So we consulted… More Dr. Kharkar. He tried a few medicines, and within 1.5-2 months now the patient is feeling very well now. There are no seizures for 14 days currently.Dr. tried to keep medicines as minimum as possible. He also tried to keep the cost of the treatment minimum.When some of the medicines started showing side-effects, he was quick to switch the medicines to the better options.Overall I think we are getting a best of the available treatments. We thank you very much Dr. Kharkar.
Dr Kharkar is gem of a doctor with tremendous patience, empathy, genuine concern for his patients .He guides them very methodically & scientifically… More for their neurological ill healthOur epilepsy patient is extremely happy with his treatment , Patient feels better by just visiting him too!May his selfless service to humanity flourish to reach all the needy patients!!
I consulted Dr Sidharth for my sister who has become very hyper and aggressive and we could not understand the issue. Keeping in mind she is someone with… More special needs Dr Sidharth was extremely understanding of the situation and did not put her through unnecessary investigation and avoided a very long stay at the hospital. He was infact more keen on her returning home to her natural environment. We highly appreciate Dr Sidharth for his effort and for looking into the matter with utmost care. It was a very difficult decision for my family to get my sister admitted but we are glad we did it under his care.Thankyou Doc.
my name is prashant purohit. I m become completely bed ridden from last 9 months and was unable to walk. I couldnt find out the cause even after visiting… More many doctors and many hospital in Ahmedabad nd jodhpur.started losing hope. A good friend of mine suggested to visit a neurologist. After searching a lot, I came to know about Dr. Siddharth Kharkar and took his appointment in Nanavati Hospital. He examined and said that he suffered from \u201cPKD(PAROXYSMAL KNESIGENIC DYSKNESIA\u201c. He assured us to reverse this in 5 days time. And indeed this happened. I started recovering miraculously. today I am fully well fit I m walking as normal . Many Many thanks to Dr. Siddharth Kharkhar sir for giving me a new life.
Dr. Kharkar is truly exceptional. He is extremely knowledgeable. But simultaneously, he is extremely patient and kind - taking the time and care to respond… More to all the questions. It is rare to come across a doctor who is not in a hurry to get on to the next patient, but instead, focuses on the one in front with full attention, expertise and compassion. A great experience.
We visited Dr. Kharkhar for treatment regarding my mum - who is a multi-stroke patient and has aphasia. Certain medications were creating complications… More with her condition and Dr. Kharkhar was able to help mitigate the issue. We found him and his approach to be incredibly compassionate, considerate, individualized and patient-friendly. He advice is astute, up-to-date and empathetic. His treatment always comes from a deeply human place and is about seeing how to help the patient and their caregivers feel more at ease. Something that is quite rare and refreshing within the medical community.We feel that he genuinely cares about the patients that he is treating and is always kind and respectful in his communication. Moreover, his admin team is very efficient and prompt and it's a pleasure to deal with them.Would highly recommend Dr Kharkhar himself - though we must say our experience with Nanavati hospital itself has been less than ideal.Hope this helps.
I have been visiting Dr Kharkar for treatment of my father. He is a very friendly doctor. He listens to our concerns with lot of patience. He also explains… More the issue in much greater details. He has really been of great help. My father is much better now.
One of the best Dr. Gives complete attention and time to listen to patient's history, issues. Explains various options of treatment with pros and… More cons.
Exceptional experience with an expert,Dr. Kharkar is a knowledge house. It is rare nowadays to find doctors with patience, knowledge, and a flair for… More handling patient’s questions, besides Dr. Kharkar’s bedside manners are exemplary. I am privileged to be treated by such an amazing soul. I have told him and will repeat it here that “I am advancing my move back to India although I am a US Citizen, because I know I am in good hands and will be well taken care of. Thanks Dr. Kharkar for your selfless service!
Great doctor!! Really appreciate.The doctor diagnosed to my sister correctly and start treatment, she has good improvement after taking medicine prescribed… More by doctor as no epilepsy attake. We have good experience with the doctor. Thank you
