And that's where I get angry at people who are so quick to sue. We ask for faster treatments and relief for our symptoms, and then when they discover a side effect after the fact, greed takes over on the patients' side, fueled by greedy attorneys. Innocent people should not lose their careers - ok just a little vent.

paula

To Quote Paula_W...in "Update: Pergolide, Cabergoline and Heart Damage"
Quote:
See new post today: "Fast-Multiplying Lawsuits Can Stymie Medical Science, Authors Warn"

Paula, Prozac is safe in that regard. It deals with the other kind of receptor that's not linked to heart damage.

I used to take alot of ergotamine, so I'm glad my valves have been checked (actually checked for mitral valve prolapse because my mom has it and I had symptoms).

Since Mirapex is a non-ergot dopamine receptor agonist, I hope that it is not causing heart valve damage as is being seen with Permax which is also an agonist. I assume the key is whether these agonist drugs are ergot derived or not.
Ashley

http://www.cc.nih.gov/phar/updates/01jan-feb.html
Pramipexole (Mirapex®): A Brief Review

Introduction
Pramipexole, a non-ergot dopamine receptor agonist, is effective in the treatment of both early and advanced Parkinson's disease (PD). Pramipexole and ropinirole, another dopamine receptor agonist, were the first non-ergot derivatives available for the treatment of PD. Ergot-derived dopamine agonists, such as bromocriptine, have been effective in the treatment of this disorder but are associated with many side effects, some potentially irreversible (e.g., pulmonary fibrosis). Use of dopamine agonists in the treatment of Parkinson's disease may delay the introduction of levodopa in the early stages of the disease and perhaps delay the development of levodopa-associated motor fluctuations ("on/off" phenomenon) and dyskinesias related to chronic use of levodopa. In advanced PD, dopamine agonists increase "on time" in patients with levodopa-associated motor fluctuations, thereby allowing for levodopa dose reduction in some patients. The long-term effectiveness of pramipexole in PD has not been evaluated, and it is unknown whether patients will develop tolerance to the dopamine-agonist effects of pramipexole.

Description
Mirapex® (pramipexole dihydrochloride) is marketed by Pharmacia & Upjohn and is available as 0.125-, 0.25-, 0.5-, 1-, and 1.5-mg tablets.

Indication
Pramipexole is indicated for the treatment of the signs and symptoms of idiopathic Parkinson's disease.

Pharmacology
Pramipexole dihydrochloride, a benzothiazolamine derivative, is a non-ergot dopamine receptor agonist. In vitro studies suggests that pramipexole has intrinsic activity and a high degree of binding specificity at the D2 subfamily of dopamine receptors. Known dopamine receptor subtypes include D2, D3, and D4. The D2 specificity and intrinsic activity of pramipexole is greater than that for the other available ergot-derived dopamine agonists, bromocriptine and pergolide. Pramipexole binds with higher affinity to D3 compared to D2 or D4 receptor subtypes, but the relevance of this specificity is not known. Pramipexole is believed to also stimulate presynaptic dopamine autoreceptors, with resultant inhibition of synthesis and release of dopamine in intact dopaminergic synapses. However, when presynaptic fibers are degenerated and postsynaptic receptors are hypersensitive, pramipexole exerts postsynaptic dopamine agonist activity. Although the precise mechanism of action of pramipexole for the treatment of PD is not known, it is believed to be related to stimulation of postsynaptic dopamine receptors in the striatum. Pramipexole binds with moderate affinity to a2-adrenergic receptors but has little or no affinity for a1, b-adrenergic, acetylcholine, D1, or serotonin receptors.

Pharmacokinetics
Pramipexole is rapidly absorbed, with maximal plasma concentrations achieved in 2 hours. The absolute bioavailability is > 90%, and food does not affect extent of absorption but may increase the time to maximal plasma concentrations by nearly 1 hour. Pramipexole is extensively distributed in body tissues and has a volume of distribution of about 500 L. Approximatly 15% of the drug is bound to plasma proteins. Pramipexole displays linear pharmacokinetics over the entire clinical dose range. Its terminal half-life is 8 hours in young, healthy volunteers and about 12 hours in elderly volunteers.

I was on Permax for a year and a half from Aug. 2002 to Jan. 2004. My final dose was about 0.6 mg. (I think) three times a day, the nausea was so bad that I couldn't tolerate any more. Has anyone read if it says anywhere in the research whether that amount would cause problems with the valves?

Hi Wendy,
Regardless of the amount or length of time you took it or the dosage an echocardiogram is recommended to rule out valvulopathy which has an increased chance of occurring in people who have previously taken Permax.
Your G.P. or neurologist will probably be aware of the reports regarding the increased chance of it in pts who took Permax.
If they're not you can teach them something they don't know and in return they can find you a cardiologist who will order an echocardiogram and hopefully report you have no evidence of valvulopathy.
Cheers,
Lee