Buspirone and Zolmitriptan Combination for Dyskinesia: A Randomized, Controlled, Crossover Study

Document Type

Article

Publication Date

3-1-2024

Publication Title

Movement disorders

Abstract

BACKGROUND: Preclinical evidence suggests that co-administration of the 5-HT(1A) agonist buspirone and the 5-HT(1B/1D) agonist zolmitriptan act synergistically to reduce dyskinesia to a greater extent than that achieved by either drug alone.

OBJECTIVES: Assess the therapeutic potential of a fixed-dose buspirone and zolmitriptan combination in Parkinson's disease (PD) patients with levodopa-induced dyskinesia.

METHODS: Single-center, randomized, placebo-controlled, two-way crossover study (NCT02439203) of a fixed-dose buspirone/zolmitriptan regimen (10/1.25 mg three times a day) in 30 patients with PD experiencing at least moderately disabling peak-effect dyskinesia.

RESULTS: Seven days of treatment with buspirone/zolmitriptan added to levodopa significantly reduced dyskinesia as assessed by Abnormal Involuntary Movement Scale scores versus placebo (mean treatment effect vs. placebo: -4.2 [-6.1, -2.3]) without significantly worsening Unified Parkinson's Disease Rating Scale (UPDRS) Part III (ON) scores (mean treatment effect vs. placebo: 0.6 [-0.1, 1.3]). No serious adverse events were reported.

CONCLUSIONS: In this proof-of-concept study, addition of buspirone/zolmitriptan to the patients' PD medication regimen significantly reduced dyskinesia severity without worsening motor function. © 2024 International Parkinson and Movement Disorder Society.

Medical Subject Headings

Humans; Levodopa; Antiparkinson Agents; Buspirone; Cross-Over Studies; Serotonin; Dyskinesia, Drug-Induced; Parkinson Disease; Double-Blind Method; Tryptamines; Oxazolidinones

PubMed ID

38314643

ePublication

ePub ahead of print

Volume

39

Issue

3

First Page

613

Last Page

618

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