Parkinson’s Drugs Hurt the Heart

Two new studies published recently in The New England Journal of Medicine have found that two drugs used for treatment of Parkinson’s disease cause heavy damage to the heart. Researchers found these drugs cause the same kind of damage to the heart that caused the withdrawal of the diet drug “fen-phen.”

Researchers studied the effects of two major drugs – pergolide and cabergoline on the heart. Records of 11,417 patients in Britain and 245 patients in Italy were studied in two separate studies – both covering the same medications. The researchers found there was a sharply higher risk of heart valve damage in patients on these two drugs as compared to those on other therapies.

In the British study, patients on pergolide were found to be at 7.1 times higher risk of developing heart valve damage than those taking other treatments. Those on the highest dosage had as much as 37 times higher risk. On the other hand, patients taking cabergoline had 4.9 times higher risk of developing heart value damage, with higher doses causing this risk to increase up to 50.3 times.

The Italian study consisted of 245 people of whom 155 had Parkinson’s disease. The diseased volunteers were split into three groups with one receiving pergolide, another receiving cabergoline while the third one got an alternative treatment. The non-diseased control group received nothing.

Results showed heart damage in 23.4% of the patients on pergolide while the figure was 28.6% among patients on cabergoline. The control group had just 5.6% patients with heart damage.

“These are huge risks,” said Bryan Roth, a researcher at the University of North Carolina, Chapel Hill. He added that these risks are similar to the damage inflicted by the now withdrawn drug fen-phen.

The study findings reinforce the findings of other smaller studies that found heart damage can be caused by drugs that activate a cellular receptor known as 5-HT2b. This kind of heart damage can be serious and can lead to heart failure and sudden death. Such drugs include the migraine headache drug ergotamine and the amphetamine derivative – ecstasy.

“We recommend that physicians not prescribe drugs that have this biochemical property,” said Roth while commenting on the trials’ results. “We recommend that every drug be screened at this receptor before it goes into humans,” Roth added. “It costs just pennies per drug for such a screen.”

Manufacturers of cabergoline on the other hand opine that benefits from the drug far outweigh the increased risk of heart valve damage and argued that this risk is clearly noted in the drug’s package insert label.

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