Dopamine Agonists Not Good for the Elderly

I was listening to Dr. Stanley Fahn, supposed to be a world leading expert in movement disorders. He says, "Elderly people have poor tolerance to the agonist compared to levodopa: more hallucinations and confusion. Also, the prime reason for starting an agonist is to delay motor fluctuations; these are less common in the elderly population. I avoid dopamine agonists in patients with any cognitive decline, which is predominantly in the elderly population." Any thoughts?

Also, here is the link to his talk:

4 Replies

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  • Yet another reason to avoid dopamine agonists("DAs"). I was disabled for a month - unable to stand without fainting - due to DA caused impairment of my postural blood pressure regulation. healthunlocked.com/parkinso...

    Turns out to be common with DAs: jamanetwork.com/journals/ja...

    Not to mention all the sad stories of seniors losing everything due to DA induced compulsive gambling.

    Only mess with DAs if C/L is not enough.

  • I am a little confused by the term agonist...are agonists the carbo part of carbo/leva or are they prescriptions like selegiline or rasagiline?

  • tbirchf,

    They are a class of drugs that mimics the effects of dopamine. They act like dopamine to stimulate one's nerve cells. They are drugs like apomorphine, pramipexole, ropinirole and rotigotine.

    Here is an explanatory link:

    parkinson.org/understanding...

    Best,

    Sarah

  • Thanks for the explanation and the link, Sarah. My husband took selegiline for a while with his carbo/leva until we switched neurologists and the new neuro took him off selegiline. Now only taking carbo/leva 3x a day.

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