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Pergolide use associated with valvular disease.

SAN FRANCISCO -- The use of pergolide in patients with Parkinson's disease is associated with a markedly increased risk of developing cardiac valvular insufficiency, Richard B. Dewey Jr., M.D., said at the annual meeting of the American Academy of Neurology.

Since alternative dopamine agonists not derived from ergot are available, serious consideration should be given to switching patients from pergolide to another drug, added Dr. Dewey, a neurologist at the University of Texas Southwestern Medical Center, Dallas.

Based on a few anecdotal reports that suggested a possible increase in valvular heart disease in individuals treated with pergolide, Dr. Dewey sent cautionary letters to more than 200 patients who were taking the drug for Parkinson's disease and urged those who wished to continue on pergolide despite the possible hazards to come in for an echocardiographic examination.

Of the 46 patients who did so, some degree of valvular insufficiency was identified in 41, or 89%.

Compared with an age-matched control group from the Framingham Heart Study, the pergolide-treated patients had a roughly 3-fold increased risk of nonphysiologic regurgitation at the aortic, tricuspid, and mitral valve sites, and an 18-fold increased risk of clinically significant tricuspid regurgitation.

The greater the lifetime use of pergolide, the worse a patient's composite echocardiographic valvular regurgitation score, he continued.

One of the four patients with clinically significant valvular regurgitation had improvement of the echocardiographic findings 7 months after discontinuing pergolide.
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Title Annotation:Across Specialties
Author:Jancin, Bruce
Publication:Clinical Psychiatry News
Article Type:Brief Article
Geographic Code:1USA
Date:Nov 1, 2004
Words:233
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