Abstract

Helena Sarac

Apomorphine is a potent dopaminergic agonist with equivalent antiparkinsonian efficacy to levodopa. It was first licensed in the UK for use in the treatment of Parkinson’s disease (PD) in 1993 on the basis of findings from an open-label, comparative study. Although several routes have been tried, subcutaneous administration, either as intermittent injections or continuous infusion, is so far the best in the treatment of PD with severe motor fluctuations not optimally controlled by oral medication. Numerous shortterm and long-term, open-label, uncontrolled studies have shown the stable efficacy of apomorphine infusion in reducing off time, with reductions of up to 80% reported, dyskinesias and levodopa dose. Neuropsychiatric side effects occur, but the influence of apomorphine on these remains controversial.