BMJ 1998;316:641-641 ( 28 February )

Editorials

Subcutaneous apomorphine in Parkinson's disease

Effective yet underused

The first 150 words of the full text of this article appear below.

Over 40 years have passed since Schwab and colleagues reported the beneficial effect of apomorphine hydrochloride in Parkinson's disease.1 In 1979 Corsini et al reported the successful use of subcutaneous apomorphine in combination with domperidone,2 and this was confirmed by a series of experiments by Hardie et al.3 More recently, in 1988, Stibe et al described the successful use of continuous subcutaneous infusion of apomorphine in overcoming refractory on-off oscillations in Parkinson's disease.4 Since then at least 16 papers, mostly using open label designs (except two double blind placebo controlled studies), have been published confirming the efficacy of apomorphine given as subcutaneous "rescue" injection or continuous infusion using an automated syringe driver in Parkinson's disease.6 Apomorphine received regulatory approval in Britain in 1993, but, despite its efficacy, it remains largely underused.

The motor response to apomorphine is indistinguishable from that to levodopa, and subcutaneous apomorphine is almost 100% bioavailable with a rapid onset of action . . . [Full text of this article]
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Extra cost of subcutaneous apomorphine would pay for personal nurses
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  • Koller, W., Stacy, M. (2004). Other formulations and future considerations for apomorphine for subcutaneous injection therapy. Neurology 62: S22-S26 [Abstract] [Full text]  
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  • CHAUDHURI, K R., APPIAH-KUBI, L S, TRENKWALDER, C (2001). Restless legs syndrome. J. Neurol. Neurosurg. Psychiatry 71: 143-146 [Full text]  
  • (1999). Developments in the treatment of Parkinson's disease. DTB 37: 36-40 [Abstract] [Full text]  
  • Hill-Smith, I. (1998). Extra cost of subcutaneous apomorphine would pay for personal nurses. BMJ 317: 602a-602 [Full text]  
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