Parkinson's Drugs Can Damage Heart Valves

Pergolide and cabergoline have same effect as now-banned Fen-phen, studies find.

By Steven Reinberg
HealthDay Reporter
Wednesday, January 3, 2007; 12:00 AM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

WEDNESDAY, Jan. 3 (HealthDay News) -- Two drugs commonly used to treat Parkinson's disease can cause harm to heart valves, according to two studies in the Jan. 4 New England Journal of Medicine.

The drugs, pergolide and cabergoline, are both from a class of medications called "ergot-derived dopamine receptor agonists." Ergot is a fungus, and ergot-derived drugs are used not only in the treatment of Parkinson's but also for restless leg syndrome and migraine headaches.

Ergot-derived dopamine receptor agonists were also in the now banned diet drug Fen-phen -- also associated with heart valve disease.

"We uncovered the biomedical reason why Fen-phen had particular side effects on the heart," said Dr. Bryan L. Roth, of the Department of Pharmacology at the University of North Carolina and author of an accompanying journal editorial.

"We evaluated other medications and predicted that they would have the same side effect on the heart," he said. "Our predictions were verified in these two studies."

Based on the new findings, Roth wants the U.S. Food and Drug Administration to look at all drugs that have this side effect with an eye to banning pergolide (brand named Permax) and cabergoline (Dostinex). "This side effect is very dangerous," he said. "It could result in an individual's death or undergoing valve replacement surgery," he added.

These types of drugs interact with a receptor in the heart valve, causing the valve to overgrow and become floppy and leaky, Roth explained.

In the first report, Dr. Edeltraut Garbe, from the Institute of Clinical Pharmacology, Charité, University Medicine, Berlin, and colleagues collected data on more than 11,000 people 40 to 80 years of age who were taking anti-Parkinson's drugs between 1988 and 2005.

The researchers found that, among 31 patients with newly diagnosed cardiac valve problems, six were taking pergolide, six were taking cabergoline, and 19 had not taken any dopamine agonist in the past year.

Almost 30 percent of the patients taking pergolide or cabergoline were at increased risk for heart valve problems.