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Pramipexole/ropinirole Pisa syndrome in elderly patients: 2 case reports Two elderly women with parkinsonism developed Pisa syndrome during treatment with pramipexole or ropinirole [routes and durations of treatments to reactions onset not stated]. A 70-year-old woman received pramipexole [dosage not stated] and developed a lateral flexion of her trunk to the side most affected by parkinsonism. The issue became worse when pramipexole was increased. Her Pisa syndrome improved on discontinuing pramipexole. A 65-year-old woman was receiving ropinirole and had reached 15mg/day taken in three doses. Her other medications included rasagiline and levodopa/carbidopa/ entacapone. When she had reached the ropinirole 15mg dose, she developed severe lateralisation of her trunk with slight antiflexion and torsion. Her Pisa syndrome improved on discontinuing ropinirole and her abnormal trunk position had disappeared in a few months. Author comment: "We report the development of reversible Pisa syndrome in two parkinsonian patients during treatment with ropinirole and pramipexole." Gallardo MJ, et al. Pisa syndrome induced by dopamine agonists, in two parkinsonian patients Movement Disorders 27 (Suppl. S1): abstr. 370, Jun 2012. Available from: URL: http://onlinelibrary.wiley.com/doi/10.1002/mds.25051/pdf 803075264 Spain

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Reactions 11 Aug 2012 No. 1414