TRIVASTAL L.A.: a reference dopamine agonist for Parkinson's disease treatment and cerebral aging

TRIVASTAL L.A. is a selective D2/D3 dopamine receptor agonist with additional α2-noradrenergic properties, effective in two major pathologies: Parkinson's disease and cerebral aging.

In Parkinson's disease, by correcting the dopamine deficit of the postsynaptic D₂ receptors of the nigrostriatal pathway, TRIVASTAL L.A.. offers powerful efficacy in monotherapy, on the three major signs of Parkinson's disease, rigidity, bradykinesia, and tremor, with less dyskinesia than levodopa.^1,2 TRIVASTAL L.A. is also an effective treatment in adjunct to levodopa at all stages of Parkinson's disease, on the major signs, with a dramatic impact on tremor.^3-7 Thanks to its additional presynaptic α₂-adrenoreceptor antagonism property,⁸ TRIVASTAL L.A. enhances central noradrenergic neurotransmission and widens its antiparkinsonian efficacy to symptoms that withstand levodopa such as postural instability and gait disorders.⁹

Furthermore, TRIVASTAL L.A. is generally well-tolerated in monotherapy as well as in combination with levodopa^1,5 and causes an increase in vigilance and alertness which may be related to its α2-noradrenergic properties.^10,11 Concerning TRIVASTAL L.A.'s use, in monotherapy, patients can be titrated to an effective dosage of 1 to 4 tablets a day within 3 to 6 weeks. In combination with levodopa, a dosage of 1 to 2 tablets a day can be achieved in 1 to 3 weeks. The initiation of TRIVASTAL L.A. is therefore both shorter and simpler than for other dopamine agonists used in Parkinson's disease.

In cerebral aging, by correcting the dopamine deficit of the postsynaptic D2/D3 receptors of the mesocortical and mesolimbic pathways, TRIVASTAL L.A. provides an effective treatment of cognitive disorders in the elderly. Indeed, TRIVASTAL L.A., compared with placebo and reference cerebral vasodilators, leads to significant improvement of disorders which make up the clinical picture of cerebral dopamine deficiency: attention, concentration, and memory, as well as mood disorders.^12,13 Recently, an Indian study on TRIVASTAL L.A. has demonstrated a significant global cognitive improvement (Mini-Mental State) versus placebo in patients with mild cognitive impairment.¹⁴ Furthermore, TRIVASTAL L.A.'s additional α ²-noradrenergic property reinforces its positive impact on cognitive and motor functions.^15,16 In addition, TRIVASTAL L.A. also provides an effective dopamine impulse with additional noradrenergic reinforcement in the ENT and ophthalmic manifestations of ageing dopamine deficiency. Thus, TRIVASTAL L.A. significantly improves vertigo, tinnitus, hypoacusis.^17-19 It also significantly improves visual acuity, floaters, and contrast sensitivity.^20-22 By reinforcing the noradrenergic transmission, TRIVASTAL L.A. may prevent distractibility by irrelevant stimuli.^15,16 Signals are better perceived and better understood by patients, who are thus more attentive and intellectually alert, with only 1 tablet once a day, and 2 tablets in severe cases.

Attached References

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