Bromocriptine is effective in early Parkinson’s disease

Clinical question: 
How effective and safe is bromocriptine (BR) monotherapy as an alternative to levodopa (LD) therapy in patients with early Parkinson’s disease?
Bottom line: 
Bromocriptine monotherapy had a comparable effect to levodopa therapy on impairment and disability in patients with early Parkinson’s disease able to tolerate bromocriptine. The use of bromocriptine in early treatment may be of benefit in delaying the motor complications and dyskinesias associated with levodopa therapy.
Caveat: 
The trials were of low methodological quality and were heterogeneous so that the authors were unable to perform a meta-analysis. The conclusions were made on the basis of a qualitative review of the data. Overall, there were more dropouts (statistically significant) in the BR group because of inadequate therapeutic response or intolerable side effects, such as nausea and confusion.
Context: 
Currently, the best treatment for Parkinson’s disease is LD. However, as the number of LD treatment years increases, new disabling fluctuations of movement occur. To overcome this problem, BR has been tried as an alternative drug.
Review CD#: 
CD002258
PEARLS No: 
68
Date: 
May, 2008
Authored by: 
Brian R McAvoy