March 22, 2026

@michaelokun

Who doesn't love a scientific 'double feature?' A second paper also just came out in JAMA Neurology and this one featuring Tavapadon as an 'add on therapy' to your current Parkinson's drug regimen? The drug is a new D1/D5 agonist and the authors were hoping when they conducted the study it would have less worrisome side effects vs. conventional dopamine agonists. The folks in the study were experiencing motor fluctuations. This is a different paper on the same drug and the first author on this one was Hubert Fernandez. The other paper by Pahwa was focused on using the drug in early Parkinson's. Key points: - Tavapadon increased daily 'good on time' by about 1 hour compared to placebo, meaning more time w/ smoother movement and fewer symptoms. - Tavapadon reduced daily off time by nearly 1 hour more than placebo, meaning fewer periods when symptoms return between doses. - Most side effects were mild to moderate, w/ nausea, dyskinesia and dizziness being the most common. My take: We have been stuck in a D2/D3 world for a long time and this study opens the door to a different dopamine agonist strategy. Will there be less impulse control disorders (ICDs) in clinical practice? We shall see as this drug will soon be in use. https://jamanetwork.com/journals/jamaneurology/fullarticle/2846847 #michaelokun #fixelinstitute #parkinson