Twenty-four patients with idiopathic Parkinson™s disease were followed up perspectively during a 6-month period to test the incidence of undesirable effects of the preparation pergolide mesylate (Permax ® ). Pergolide was administered to patients as adjuvant treatment to current medicamentous treatment with preparations containing L-DOPA. Before starting treatment in every patient the Unified Parkinson´s Disease Rating Scale (UPDRS) was used, the stage of the disease was assessed according to Hoehn and Yahra,the scale of daily activities according to Schwab and England, blood pressure and heart rate were assessed in a recumbent and upright position. During subsequent visits the authors assessed the effectiveness of pergolide by means of the UPDRS score parts III, IV, the duration during the wakeful state spent in dyskinesias, duration of the —offii condition of mobility and the CGI score (Clinical Global Impression) was evaluated (weeks 2, 4, 8 and 16). During every visit the authors monitored blood pressure readings, pulse rate and undesirable effects of the preparation. During week 24 (end of the investigation) again the complete UPDRS scale was tested. The mean pergolide daily dose was 2.85 ± 0.45 mg. Reduction of the total daily dose of L-DOPA (from 906 mg to 664 mg levodopa per day) or reduction of other antiparkinsonian medication was effectuated during pergolide administration in particular during development or deterioration of dyskinesias. The most frequent undesirable effects were disorders of orthostasis (14.3 % patients), gastrointestinal complaints (9.5 %), insomnia (9.5 %), hypersexuality (9.5 %). In 21 patients (87.5 %) who finished the complete follow up no significant changes were observed in the values of blood pressure or heart rate. In three patients (12.5 %) pergolide had to be discontinued prematurely - in one because of visual hallucinations, in another two because of subjective symptoms of orthostatic hypotension and gastrointestinal complaints. The total UPDRS score (reduction by 48.3 %) as well as the UPDRS III score (Motor Examination - reducti on by 56.2 %), UPDRS IV (Complications of Therapy - reduction by 40 %) and UPDRS II (Everyday Activities - reduction by 37.6 %) were significantly lower after 24 weeks of pergolide administration as compared with baseline values before treatment was started. The UPDRS I score (Thinking, Behaviour and Mood) was not significantly influenced at the end of the investigation period (reduction by 5.3 %). The time of wakefulness spent in an —offiu state was reduced by 53.0 %, the duration of dyskinesias by 29.8 %. Pergolide mesylate (Permax ® ) is an effective and safe preparation suitable for adjuvant therapy with preparations containing levodopa in the treatment of idiopathic Parkinson´s disease.

        Key words: Parkinson´s disease, pergolide mesylate, adjuvant therapy to L-DOPA