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Rotigotine for anxiety during wearing-off in Parkinson’s disease with dementia

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Abstract

Background

Wearing-off (WO) refers to the exacerbation of motor and/or non-motor symptoms of Parkinson’s disease at the end of dose of dopaminergic medications. Treatment of WO is based on modifying drug schedule, meal timetable and/or increasing dopamine replacement therapy. In advanced and/or demented patients, management of WO is often limited by scarce compliance and by cognitive, psychiatric and dysautonomic side-effects that may accompany increased dopaminergic stimulation.

Methods

Here, we report 2 patients suffering from Parkinson’s disease with dementia, who experienced anxiety as non-motor symptom of WO under stable levodopa therapy. In both cases, transdermal rotigotine (4 mg/day) was added to the original dopaminergic therapy.

Results

Rotigotine proved beneficial on symptoms of anxiety in both patients, without worsening cognitive and behavioral symptoms. During the 9-month follow-up period, there was a slight improvement of motor impairment, with no worsening of drug-related dyskinesia.

Conclusions

These preliminary results suggest that rotigotine at low dose might improve non-motor symptoms of WO in elderly patients suffering from Parkinson’s disease with dementia, without raising major safety issues.

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Conflict of interest

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Authors and Affiliations

  1. Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso - NeSMOS, “Sapienza” Università di Roma, Via di Grottarossa, 1035, 00189, Rome, Italy

    Alessandra Fanciulli & Francesco E. Pontieri

  2. Servizio Disordini del Movimento, Ospedale “Sant’Andrea”, Rome, Italy

    Alessandra Fanciulli & Francesco E. Pontieri

  3. I.R.C.C.S. “Fondazione Santa Lucia”, Rome, Italy

    Francesca Assogna, Carlo Caltagirone, Gianfranco Spalletta & Francesco E. Pontieri

  4. Dipartimento di Medicina dei Sistemi, Università “Tor Vergata” di Roma, Rome, Italy

    Carlo Caltagirone

Authors
  1. Alessandra Fanciulli
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  2. Francesca Assogna
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  3. Carlo Caltagirone
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  4. Gianfranco Spalletta
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  5. Francesco E. Pontieri
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Corresponding author

Correspondence to Francesco E. Pontieri.

Additional information

A. Fanciulli and F. Assogna these authors contributed equally to the work.

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Fanciulli, A., Assogna, F., Caltagirone, C. et al. Rotigotine for anxiety during wearing-off in Parkinson’s disease with dementia. Aging Clin Exp Res 25, 601–603 (2013). https://doi.org/10.1007/s40520-013-0136-4

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  • DOI: https://doi.org/10.1007/s40520-013-0136-4

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