Hello,
I'm currently designing a protocol in Parkinson's disease and I was wondering about the optimal timing to test motor symptoms in relation to last dose of dopamine agonist(s).
It is clear to me that standardisation of this aspect is essential, but I could not find specific literature with recommendations in this regard.
Any pointers to papers or opinions on this matter would be immensely appreciated.
Thank you
Dear Fidel
That depends primarily on the Pk of your DA agonist, i.e when you reach Cmax. Are we talking rodents or humans? And what agonist do you have in mind?
All the best
Hanna
Thanks Hanna!
We are talking about humans and my sample is most likely to be receiving L-DOPA different formulations (IR, SR, etc).
You may want to consider testing both in OFF and in ON, using the Levodopa Equivalent Dose (LED) for dopaminine agonists (DA) after e.g. 12h withdrawal. Although you may not fully clear all DA after only 12h, you may consider the patient in a 'practically defined OFF state'. A suprathreshold dose of 120% of the morning LED using dispersible madopar would then result in a practically defined ON state. Hope this helps!
For more info on LED, see: http://www.anna.asn.au/wp-content/uploads/Systematic-Review-of-Levodopa-Dose-Equivalency-Reporting-in-PD.pdf
Thanks for your response Victor, it is very helpful and the reference to the LED is also much appreciated!
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