Piribedil

Piribedil (trade names Pronoran, Trivastal Retard, Trastal, Trivastan, Clarium and others) is an antiparkinsonian agent and piperazine derivative which acts as a D2 and D3 receptor agonist. It also has α2-adrenergic antagonist properties. Treatment of Parkinson's disease (PD), either as monotherapy (without levodopa)) or in combination with L-DOPA therapy, in the early stages of the disease as well as in the advanced ones Treatment of pathological cognitive deficits in the elderly (impaired attention, motivation, memory, etc.) Treatment of dizziness in the young patients Treatment of retinal ischemic manifestations Adjunctive treatment of intermittent claudication due to peripheral vascular disease (PVD) of the lower limbs (stage 2) Adjunctive treatment of anhedonia, apathy and treatment-resistant depression in unipolar and bipolar depressives (off label) Treatment of gait disorders associated with Parkinson's disease (no related cause) and other forms of parkinsonism The drug has been shown to enhance working memory capacities in normal aging adults. In age-related memory impairment, it has a positive effect on psychophysiological state of elderly people, improving memory and attention and increasing the velocity of psychomotor reactions and lability of nervous processes. It enhances cognitive skill learning in healthy older adults. It showed a positive effect in restless legs syndrome. Administration of piribedil should be initiated with one sustained-release tablet (50 mg) daily during the first week. Dosage should then be gradually increased every week until achieving the optimal therapeutic dose: As monotherapy: three to five tablets in three to five doses daily. In combination with L-DOPA therapy: one to three tablets daily. One tablet daily at the end of the main meal. In severe cases: two tablets daily in two doses. Minor gastrointestinal upset (nausea, vomiting, flatulence, etc.