Continuous infusion of levodopa or apomorphine provide constant dopaminergic stimulations are good alternatives to deep brain stimulation to control motor fluctuations in patients with advanced Parkinson’s disease (PD). Apomorphine provides motor benefit similar to dopamine, but its long-term use is limited by compliance, mostly injection site skin reactions. Administration of levodopa/carbidopa by continuous duodenal infusion allows replacement of all oral medications and permits achievement of a satisfactory therapeutic response paralleled by a reduction in motor complication severity. However, this procedure is more invasive than apomorphine as it requires a percutaneous endoscopic gastrostomy Clinical experience with infusions shows that continuous dopaminergic stimulation of dopaminergic medications reduces dyskinesia and widens the therapeutic window in advanced PD.

Citations

Citations to this article as recorded by  

• Integrating technology into a successful apomorphine delivery program in Thailand: a 10-year journey of achievements with a five-motto concept
  Onanong Phokaewvarangkul, Nithinan Kantachadvanich, Vijittra Buranasrikul, Kanyawat Sanyawut, Saisamorn Phumphid, Chanawat Anan, Roongroj Bhidayasiri
  Frontiers in Neurology.2024;[Epub]     CrossRef
• Safety and tolerability of long-term apomorphine infusion in advanced Parkinson's disease: an Indian multi-center (APO-IND) experience
  Vinod Metta, Rajinder K. Dhamija, Lucia Batzu, Rukmini Mrudula, Natuva Sai Sampath Kumar, Arunan S., Cristian Falup-Pecurariu, Carmen Rodriguez-Blazquez, Vinay Goyal, Prashanth L.K., Kalyan Bhattacharya, Suresh Kumar, Kallol Ray Chaudhuri, Rupam Borgohain
  Scientific Reports.2023;[Epub]     CrossRef
• A Randomized Trial Assessing the Safety, Pharmacokinetics, and Efficacy During Morning Off of AZ‐009
  Eva Thijssen, Jonas den Heijer, David Puibert, Laurence Moss, Mingzu Lei, David Hasegawa, Kyo Keum, Ken Mochel, Mohammed Ezzeldin Sharaf, Tom Alfredson, Wenxiang Zeng, Emilie van Brummelen, Tatjana Naranda, Geert Jan Groeneveld
  Movement Disorders.2022; 37(4): 790.     CrossRef
• Why do ‘OFF’ periods still occur during continuous drug delivery in Parkinson’s disease?
  Silvia Rota, Daniele Urso, Daniel J. van Wamelen, Valentina Leta, Iro Boura, Per Odin, Alberto J. Espay, Peter Jenner, K. Ray Chaudhuri
  Translational Neurodegeneration.2022;[Epub]     CrossRef
• Parkinson's disease and skin
  Nicki Niemann, Andrew Billnitzer, Joseph Jankovic
  Parkinsonism & Related Disorders.2021; 82: 61.     CrossRef
• Subcutaneous apomorphine in advanced Parkinson’s disease and its use in Indian population
  Vinod Metta, Rupam Borgohain, Prashanth L Kukkle, Rukmini Mridula, Pankaj Agarwal, Asha Kishore, Vinay Goyal, Ray Chaudhuri
  Annals of Movement Disorders.2020; 3(3): 145.     CrossRef
• Apomorphine for Parkinson’s Disease: Efficacy and Safety of Current and New Formulations
  Federico Carbone, Atbin Djamshidian, Klaus Seppi, Werner Poewe
  CNS Drugs.2019; 33(9): 905.     CrossRef
• Platinum/Graphene Oxide Coated Microfabricated Arrays for Multinucleus Neural Activities Detection in the Rat Models of Parkinson’s Disease Treated by Apomorphine
  Guihua Xiao, Yilin Song, Yu Zhang, Shengwei Xu, Yu Xing, Mixia Wang, Xinxia Cai
  ACS Applied Bio Materials.2019; 2(9): 4010.     CrossRef
• Pharmacological Insights into the Use of Apomorphine in Parkinson’s Disease: Clinical Relevance
  Manon Auffret, Sophie Drapier, Marc Vérin
  Clinical Drug Investigation.2018; 38(4): 287.     CrossRef
• The Many Faces of Apomorphine: Lessons from the Past and Challenges for the Future
  Manon Auffret, Sophie Drapier, Marc Vérin
  Drugs in R&D.2018; 18(2): 91.     CrossRef
• Apomorphine en perfusion sous-cutanée continue dans la maladie de Parkinson : le point de vue pharmacologique
  M. Auffret, S. Drapier, M. Vérin, P. Sauleau
  Pratique Neurologique - FMC.2016; 7(1): 25.     CrossRef
• Apomorphine en perfusion sous-cutanée continue dans la maladie de Parkinson : le point de vue clinique
  S. Drapier, M. Auffret, M. Vérin, P. Sauleau
  Pratique Neurologique - FMC.2016; 7(1): 33.     CrossRef
• Infusion treatments and deep brain stimulation in Parkinson's Disease: The role of nursing
  Anna De Rosa, Alessandro Tessitore, Leonilda Bilo, Silvio Peluso, Giuseppe De Michele
  Geriatric Nursing.2016; 37(6): 434.     CrossRef