Pergolide removal by Ray Sahelian, M.D.
January 20 2016

Pergolide is a dopamine agonist. It works by acting in place of dopamine, a natural substance in the brain that is needed to control movement.  As of April, 2007, the Parkinson's disease drug pergolide will no longer be available on the U.S. market because of potential damage to heart valves. The dopamine agonist, was sold by Eli Lilly and Co. under the name Permax,

Pergolide side effects
Case reports and echocardiographic studies suggest that the ergot-derived dopamine agonist pergolide, used in the treatment of Parkinson's disease and restless legs syndrome, may increase the risk of cardiac-valve regurgitation.

In 2007, pergolide was withdrawn from the U.S. market for human use, after several published studies revealed a link between the drug and increased rates of valvular heart disease.

Mov Disord. 2011. The risk of valvular regurgitation in patients with Parkinson's disease treated with dopamine receptor agonists. Several observational studies suggest an association between treatment with ergoline-derived dopamine agonists and valvular regurgitation. In this article, we present an overview of the literature and conduct a meta-analysis. Observational studies addressing the frequency of moderate or severe valvular regurgitation among ergoline-treated patients with Parkinson's disease were considered for a meta-analysis. Pooled risk estimates and the risk of increased pulmonary artery pressure were calculated. The pooling of data from well-designed observational studies documented that both pergolide and cabergoline represent a substantially increased risk of developing moderate to severe valvular regurgitation. In addition, pergolide, but not cabergoline, was associated with an increase in pulmonary artery pressure. The present meta-analysis confirmed a statistically significant association between pergolide and cabergoline treatment and the risk of moderate to severe valvular regurgitation. An association between bromocriptine and valvular regurgitation cannot be entirely ruled out.

Sexual effect of pergolide
Hypersexual behaviour, frotteurism and delusional jealousy in a young parkinsonian patient during dopaminergic therapy with pergolide: A rare case of iatrogenic paraphilia.
Prog Neuropsychopharmacol Biol Psychiatry. 2006. Dipartimento di Scienze Cardiovascolari e Neurologiche, Sezione Neurologia, University of Cagliari, Italy.
Neuropsychological and psychopathological modifications induced by dopaminergic drugs in patients with Parkinson's disease (PD) are invariably not taken into sufficient consideration by the neurologist. Among the former, modifications of sexual urges and behaviours are of particular importance with regard to severity and variety of clinical pictures. Although rare, such modifications may assume the connotations of an aberrant sexual behaviour with criminal implications, in line with a diagnosis of paraphilia. The authors report the case of a 51-year-old male PD patient who, after a few years of dopaminergic treatment with pergolide, developed a paraphilic disorder, consistent with DSM-IV TR diagnosis of frotteurism, and delusional jealousy. The patient presented mild motor impairment and lack of or negligible cognitive deterioration, thus providing evidence that these disorders are not typical of advanced PD. Pergolide was reduced and quetiapine, an atypical neuroleptic, was introduced with subsequent subsiding of the paraphilic disorder and improvement of delusional jealousy.