Journal of Parkinson's Disease and Movement Disorders

Meltem Demirkıran

Çukurova Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı, Adana, Türkiye

Keywords: Apomorphine; dopamine agonist; Parkinson’s disease; pharmacokinetics; treatment.


Apomorphine, a dopamine agonist, is one of the most long-standing drugs used in the treatment of Parkinson’s disease (PD). It has gained a significant place in the treatment of moderate to advanced stage PD after the development of its subcutaneous injection form. It not only stimulates the dopaminergic receptors, but also has weak affinity to serotonergic and alpha-adrenergic receptors. The serotonergic effect is not as strong as ergotderived dopamine agonists. Its effect starts shortly after the injection and continues for about an hour. Intermittent subcutaneous injection or continuous subcutaneous infusion may be applied in patients with motor fluctuations, end-of-dose deterioration, or “on-off” conditions. Early morning dystonia is another area of usage; it eliminates painful dystonia. Generally, it has no negative effects on neuropsychiatric or cognitive functions. Thus, it is a safe treatment in patients with mild to moderate stage dementia. It is a suitable and effective treatment for PD in patients appropriately selected considering the adverse effects and contraindications.