Çiğdem Türkmen1, Banu Özen Barut2, Dilek İnce Günal1

1Department of Neurology, Marmara University Faculty of Medicine, Istanbul, Türkiye
2Department of Neurology, Health Sciences University, Kartal Dr. Lütfü Kırdar City Hospital, Istanbul, Türkiye

Keywords: Dopamine agonist, levodopa, Parkinson's disease, pedal edema.


Objectives: The purpose of this study was to determine the presence of pedal edema (PE) and its risk factors in Parkinson's disease (PD) patients.

Materials and methods: Between November 2008 and April 2009, a total of 75 outpatients (48 males, 27 females; mean age: 71±7.1 years; range, 58 to 82 years) with PD treated with levodopa and/or dopamine agonist (DA) were included in the study. Fifty patients were taking DAs such as pramipexole, piribedil, cabergoline, and ropinirole, while 25 patients were taking levodopa alone. Age, sex, disease duration, type, dose and duration of medication, and concomitant diseases were assessed as part of the study.

Results: Sixty-four percent of patients in the DA group and 40% in the levodopa group had PE, a significant difference. In the more detailed evaluation of the DA group, we found no significant difference between patients taking pramipexole, piribedil, cabergoline, and ropinirole. Pedal edema did not lead to treatment discontinuation. The association between PE and age, sex, disease duration, type, dose, duration of medication, and comorbidity was analyzed. No predisposing factors were found in PD patients with PE.

Conclusion: In conclusion, PE is more common and severe in PD patients treated with DA than in patients treated with levodopa. Levodopa can also cause PE, but the severity is mild and dose-dependent. No relationship has been established between the type of DA and PE. Therefore, PE is believed to be a class effect in patients treated with dopaminergic agents. Clinicians should be cautious about this side effect and routinely check PE after starting dopaminergic treatment.

Cite this article as: Türkmen Ç, Özen Barut B, İnce Günal D. Pedal edema in Parkinson’s disease patients treated with dopamine agonists. D J Med Sci 2023;9(1):7-11. doi: 10.5606/fng.btd.2023.123.

Ethics Committee Approval

The study protocol was approved by the Marmara University Faculty of Medicine Ethics Committee (date: 28.03.2008, no: MAR-YC-2008-0060). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Idea, concept: C.T., D.I.G.; Design, analysis, literature review, materials, references and fundings: C.T.; Control/supervision, critical review: D.I.G.; Data collection and/or processing: C.T., B.O.; Interpretation: C.T., B.O., D.I.G.; Writing the article: C.T., B.O.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/ or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.