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Results: 21 to 40 of 208

Dopamine versus no treatment to prevent renal dysfunction in indomethacin‐treated preterm newborn infants

Dopamine has not been shown to prevent adverse effects of indomethacin on the kidneys of preterm babies. Indomethacin is a drug used in preterm babies to prevent brain hemorrhage or to help close off PDA (patent ductus arteriosus ‐ when a channel between the lungs and heart does not close off after birth as it should). Indomethacin often causes fluid retention and reduced flow of urine, which can sometimes cause deterioration in kidney (renal) function. The drug dopamine is sometimes used along with indomethacin to try and prevent negative impact on the kidneys. The review found there is not enough evidence from trials to show there is any value in giving dopamine to babies being treated with indomethacin.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Effect of non-ergot dopamine agonists on health-related quality of life of patients with restless legs syndrome

This review compared the effect of non-ergot dopamine agonists (NEDAs) with placebo on health-related quality of life of patients with restless legs syndrome and concluded that NEDAs yielded improved quality of life. This was a well-conducted review; despite uncertainty over the study selection process the findings are likely to reflect the available evidence.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Adding a dopamine agonist to preexisting levodopa therapy vs levodopa therapy alone in advanced Parkinson's disease: a meta analysis

This review concluded that the adjunctive use of dopamine agonists with levodopa, particularly non-ergots, could provide significant improvements in patient functioning and motor symptoms in patients with Parkinson's disease not controlled by levodopa therapy alone, but there was an increased risk of some adverse events. These conclusions appear to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Parkinson's Disease: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care

It is almost 200 years since James Parkinson described the major symptoms of the disease that came to bear his name. Slowly but surely our understanding of the disease has improved and effective treatment has been developed, but Parkinson’s disease remains a huge challenge to those who suffer from it and to those involved in its management. In addition to the difficulties common to other disabling neurological conditions, the management of Parkinson’s disease must take into account the fact that the mainstay of pharmacological treatment, levodopa, can eventually produce dyskinesia and motor fluctuation. Furthermore, there are a number of agents besides levodopa that can help parkinsonian symptoms, and there is the enticing but unconfirmed prospect that other treatments might protect against worsening neurological disability. Thus, a considerable degree of judgement is required in tailoring individual therapy and in timing treatment initiation. It is hoped that this guideline on Parkinson’s disease will be of considerable help to those involved at all levels in these difficult management decisions. The guideline has been produced using standard NICE methodology and is therefore based on a thorough search for best evidence.

NICE Clinical Guidelines - National Collaborating Centre for Chronic Conditions (UK).

Version: 2006
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Insufficient data are available on the benefits of the COMT inhibitor tolcapone compared with the dopamine agonists bromocriptine and pergolide in relieving the symptoms of later Parkinson's disease.

As Parkinson's disease progresses the control of the symptoms often requires the addition of other drugs to levodopa. The principle aim of COMT inhibitor therapy is to increase the duration of effect of each levodopa dose and thus reduce the time patients spend in the relatively immobile 'off' phase. However other drugs such as dopamine agonists can also be used at this stage of the disease. This review found that the COMT inhibitor tolcapone as an adjuvant to levodopa treatment had a similar level of benefits as two dopamine agonists, bromocriptine and pergolide. There was no significant difference in efficacy between the adjuvant tolcapone and adjuvant bromocriptine or pergolide in the medium‐term. Tolcapone produced nausea less often than these agonists but there was some evidence of liver function abnormalities with tolcapone. Post‐marketing surveillance identified three cases of fatal hepatic toxicity in patients treated with tolcapone. As a result, tolcapone has been withdrawn from some countries and severe restrictions on its use have been imposed in others.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Dopamine agonist therapy in early Parkinson's disease

This 'umbrella' meta‐analysis assesses dopamine agonists as a drug class in early Parkinson's disease. Twenty‐nine eligible trials, involving 5247 participants, were identified. It confirms reports from individual trials that motor complications are reduced with dopamine agonists compared to levodopa, but also demonstrates that other important side‐effects are increased and symptom control is poorer with agonists. Unfortunately, the balance of risks and benefits remains unclear highlighting the need for further studies assessing patient‐rated overall quality of life and economic measures as their primary outcomes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Dopamine for prevention of morbidity and mortality in term newborn infants with suspected perinatal asphyxia

Dopamine to improve outcomes in newborn infants with a suspected lack of oxygen during birth. A lack of oxygen around the time of birth (perinatal asphyxia) can cause death and long‐term illness in newborn infants. It is indicated by a low Apgar score five minutes after birth and acidic umbilical cord blood (acidosis). An infant experiencing asphyxia may need urgent resuscitation, oxygen and supported breathing (assisted ventilation). Often they have low blood pressure and poor heart function. The drug dopamine stimulates the heart and is used to improve blood flow to the brain and other organs to reduce brain and other organ damage. Possible adverse events from giving such an agent include damage with the umbilical venous catheter and heart irregularities (arrhythmias). The review authors searched the medical literature and were able to find only one small randomised controlled trial. The 14 infants included in the trial had a birthweight over 2000 g and were enrolled at a mean age of 10 hours. They had received ventilatory support and fluid expansion after birth. Infants treated with low dose dopamine (2.5 microg/kg/min) did not differ from the infants receiving placebo (dextrose water) in the number who died before discharge from hospital. Neurodevelopmental disability was similar in both groups, in all infants randomised and in survivors. The timing of assessments was variable. These findings are limited with only one small study in which three of 12 survivors were lost to follow up.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Dopamine agonists for restless legs syndrome

We could include 38 trials in the meta‐analyses which investigated the efficacy and safety of dopamine agonist treatment compared to placebo or to other treatments for RLS. The studies were performed mostly in European and Northern American countries. Treatment durations varied from one week to seven months, but most treatments had durations of one to 12 weeks. Patients suffered from moderate to severe RLS and were treated with the dopamine agonists cabergoline, lisuride, pergolide, pramipexole, ropinirole, rotigotine, and sumanirole.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Dopamine versus dobutamine for hypotensive preterm infants

Dopamine improves low blood pressure (hypotension) in preterm babies more effectively than dobutamine in the short‐term, but evidence on safety and long‐term effectiveness is needed. Hypotension may cause brain injury and other serious problems for preterm babies (born before 37 weeks). Treatment aims to maintain blood flow to the brain and other organs, by using fluids or drugs to increase blood pressure. Inotrope drugs, including dopamine and dobutamine, are commonly used to increase blood pressure. However, the safest and most effective drug for treating hypotension in preterm babies has been unclear. The review found that dopamine was more effective than dobutamine for short‐term treatment, but the effects of these drugs on long‐term outcomes is unknown. More trials are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Tolerability and safety of ropinirole versus other dopamine agonists and levodopa in the treatment of Parkinson's disease: meta-analysis of randomized controlled trials

This review concluded that dopamine agonists, including ropinirole, exhibited a higher incidence of adverse effects than placebo. Ropinirole had a similar profile to other dopamine agonists in terms of adverse events. The level of clinical heterogeneity, reliance on indirect comparisons and the relatively limited search mean that some caution is required in interpreting the conclusions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Dopamine agents for hepatic encephalopathy

Hepatic encephalopathy is a serious complication of severe liver disease. The disease is often fluctuating with a wide spectrum of symptoms ranging from minor, not readily discernible signs to deep coma. Symptoms often develop in connection to stress related to infection, dehydration, obstipation, or gastrointestinal bleeding. The exact underlying mechanisms behind the disease development are not known. Experimental studies suggest that the mental changes seen in hepatic encephalopathy reflect changes in neurotransmitters in the brain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Cabergoline therapy and the risk of cardiac valve regurgitation in patients with hyperprolactinemia: a meta-analysis from clinical studies

The authors concluded that patients with hyperprolactinaemia who were treated with cabergoline were at increased risk of tricuspid valve regurgitation. The authors? conclusions appeared to be supported by the limited evidence, but lack of reporting of review methods and study quality mean that their reliability is uncertain.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Smoking cessation in severe mental illness: what works?

The authors concluded treating tobacco dependence was effective in patients with severe mental illness. Treatments that worked in the general population worked for those with severe mental illness and appeared approximately equally effective. Treating tobacco dependence in patients with stable psychiatric conditions did not worsen mental state. The authors' conclusions reflect the evidence presented and are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Effect of ropinirole on sleep outcomes in patients with restless legs syndrome: meta-analysis of pooled individual patient data from randomized controlled trials

This review concluded that ropinirole improved sleep quantity and adequacy and lessened sleep disturbance and daytime somnolence in patients with moderate to severe primary restless leg syndrome. The authors acknowledged a number of limitations of their review and the conclusions should be treated with some caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Comparison of the risk of adverse events with pramipexole and ropinirole in patients with Parkinson's disease: a meta-analysis

This review compared the adverse effects of pramipexole and ropinirole with levodopa and placebo in the treatment of Parkinson's disease. The authors concluded that, compared with placebo, ropinirole appears to increase rates of hypotension and somnolence more than pramipexole, while pramipexole increases hallucinations more than ropinirole. These drugs were not compared directly, thus the authors' conclusions may not be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

EFNS guidelines on management of restless legs syndrome and periodic limb movement disorder in sleep

The authors concluded that level A recommendations support the use of cabergoline, gabapentin, pergolide, ropinirole, and short-term levodopa and transdermal rotigotine for primary restless leg syndrome. The evidence appears to support the authors? conclusions, but the poor reporting of review methods makes it difficult to comment on the reliability of these conclusions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Should domperidone be used for the treatment of gastro-oesophageal reflux in children: systematic review of randomized controlled trials in children aged 1 month to 11 years old

This review assessed the efficacy of domperidone for symptoms of gastro-oesophageal reflux and gastro-oesophageal reflux disease in children. The authors concluded that there is no strong evidence to support the use of domperidone. Despite limitations to the review, the authors' conclusion regarding the limitations of the evidence appear reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Are there gender differences in smoking cessation, with and without bupropion: pooled- and meta-analyses of clinical trials of Bupropion SR

This review found that Bupropion SR is an effective smoking cessation aid for both men and women. However, women have less success at quitting than men, regardless of whether treated with Bupropion SR or placebo. Given that the quality of the original studies was not assessed, a limited search was employed and the review methods were not reported, the reliability of the authors' conclusions is weakened considerably.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Comparative benefits and harms of competing medications for adults with attention-deficit hyperactivity disorder: a systematic review and indirect comparison meta-analysis

This generally well-conducted review assessed the efficacy and safety of treatments for attention-deficit hyperactivity disorder in adults. The authors concluded that the use of immediate release methylphenidate as a first-line treatment was supported. The questionable quality of many of the included studies and some concerns over the appropriateness of the synthesis may mean these conclusions were overstated.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Parkinson’s disease: Can mobility exercises help?

People with Parkinson’s disease can improve their flexibility and coordination with mobility exercises. Regular training can help them cope better with everyday activities.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: September 27, 2012

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