Dopamine Agonists - Tardive Dyskinesia Treatment

An agonist is a medication that enables a process or a biological response. An antagonist inhibits those same processes and responses. The symptoms of tardive dyskinesia are the result of the side effects of medications known as dopamine antagonists.

Therefore, the use of dopamine agonists to treat these symptoms would seem logical, but this is not necessarily the case. Tardive dyskinesia is a complex movement disorder that affects every such patient differently. As a result, treatment is a highly individualized issue that varies from one person to another.

The D-2 Dopamine Receptor

Although there are five distinct types of dopamine receptors, they fall into two broad categories: excitatory and inhibitory. As the labels suggest, the former activates a process, while the latter prevents it or regulates it in some way. The D2 receptor falls into the latter category. When the dopamine process is interrupted, the result can be any one of a wide range of neuro-psychiatric and movement disorders that can include not only tardive dyskinesia, but Tourette's syndrome, Parkinson's disease and others.

Role of an Agonist

A dopamine receptor agonist works in the reverse manner, activating the receptor process and enabling it to function properly. Trade names under which these medications have been sold include Parlodel, Dostinex, Mirapex, Requip, Apokin and Neupro. Other dopamine agonists used to treat Parkinson's disease include Permax, which was withdrawn from the market in early 2007 after it was discovered to cause damage to the heart valve.

Other Side Effects

Dopamine agonists are known to cause a number of serious side effects that include:

Nausea
Abnormal weight change
Sleep difficulties
Dizziness
Sudden drops in blood pressure
A worsening of symptoms (dyskinetic as well as neurological)

The unfortunate fact is that once tardive dyskinesia symptoms become established, they are usually irreversible. However, one study conducted in the late 1970s showed that a patient actually improved when he was administered low doses of levodopa (a naturally occurring amino acid used to treat Parkinson's disease and some types of dystonia) in conjunction with an opium byproduct called apomorphine.

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