Effects of Ropinirole on Nonmotor Symptoms of Parkinson Disease

Abstract

To evaluate the effects of ropinirole on selected nonmotor symptoms of Parkinson's disease (PD), including anxiety, depressive symptoms, sleep disturbances/excessive daytime sleepiness, and sexual functions. Forty-four consecutive PD patients with or without motor complications (MC+ group and MC- group, respectively); 6-month prospective study; scales administered in the "on" motor state: Unified Parkinson's Disease Rating Scale, Hamilton Anxiety Scale (HAMA), Montgomery-Asberg Depression Rating Scale (MADRS), Parkinson's Disease Sleep Scale, Epworth Sleep Scale, International Index of Erectile Function, and Female Sexual Function Index; serum sexual hormones collected. The median ropinirole dose was 10 mg, and the median L-dopa dose was decreased in both groups. In addition to motor symptoms and motor complications improvement, both median HAMA and MADRS scores dropped significantly in MC+ group; patients in our MC- group had little or no anxiety and depression at the baseline visit. In men, the baseline anxiety score was negatively correlated with the serum testosterone level. We did not observe any changes in the scales assessing sleep and sexual functions. Changes in Unified Parkinson's Disease Rating Scale III scores significantly correlated with ropinirole dosage. Changes in HAMA and MADRS correlated only with changes in Parkinson's Disease Sleep Scale scores. In addition to controlling motor symptoms, ropinirole improved both anxiety and depressive symptoms in PD patients with motor fluctuations and/or dyskinesias. Changes in mood and anxiety correlated with changes in sleep scores.