I read with interest the article by Kujawa et al1 regarding acute orthostatic hypotension on the initiation of dopamine agonist therapy in Parkinson disease. In this study, approximately 30% of patients met the criteria for orthostatic hypotension, and 30% of these were symptomatic from this complication. As the authors indicate, orthostatic hypotension is widely recognized, particularly on the initiation of dopamine agonist therapy. Indeed, a small proportion of patients experience quite significant difficulties with this adverse effect, and it is a common experience in movement disorders clinics to see patients who have previously discontinued treatment with several dopamine agonists very early because of symptomatic orthostatic hypotension.
Lang AE. Acute Orthostatic Hypotension When Starting Dopamine Agonist Therapy in Parkinson Disease: The Role of Domperidone Therapy. Arch Neurol. 2001;58(5):835. doi: