Lisuride in the treatment of parkinsonism.

Lisuride is a new effective antiparkinson agent that is useful in the management of patients in an advanced stage of parkinsonism where levodopa therapy is no longer sufficient and/or limited by 'wearing off' reactions. Patients with these problems usually respond favorably to 1.5-4.5 mg of lisuride daily provided the daily dose is built up gradually over a period of 4-8 weeks. All the clinical features of parkinsonism may be improved and the daily dose of levodopa may be reduced by 30-40%. In some instances it may be possible to give lisuride as a replacement for levodopa. Less established, however, is the potential role of lisuride in treating patients in the early stages of parkinsonism and the long-term effects of lisuride. And, as with other ergots, caution should be exercised in using lisuride if patients have a history of hypotension, hepatic dysfunction, cardiac arrhythmias, and dementia. Finally, lisuride, unlike other drugs, is highly water soluble with a nearly immediate outset of antiparkinsonian action when given intravenously and may therefore be of considerable value in the emergency treatment of severe parkinsonism.