Dopamine agonist monitoring

by Dr Belinda Kessel

This pilot audit was performed against a background of increasing use of dopamine agonists (DAs) in PD patients and awareness of potential side effects. This was a pilot audit of geriatricians (n=19) and neurologists (n=3) of whom all but one use DAs routinely to measure safety monitoring, warnings given to patients about common side effects and driving issues.

Patient information was commonly given on somnolence, confusion/hallucinations, nausea and postural hypotension, but less so on swollen ankles, and rarely on hypersexuality. Warnings about driving were generally given for patients given cabergoline, pramipexole, ropinorole, but less frequently for those prescribed pergolide. The advice on driving was largely to ‘be careful’ and occasionally to stop driving during titration.

2016 update: We now try to screen for impulse control disorders which we did not before and also ask more about sudden onset of sleep. We use the non-motor PD questionnaire for this screening, and circulate an information sheet to patients starting DA.

Click here to see the presentation slides for this audit

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