Olivopontocerebellar Atrophy Medication

Updated: Nov 11, 2014
  • Author: Christina J Azevedo, MD; Chief Editor: Selim R Benbadis, MD  more...
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Medication

Medication Summary

As previously stated, to date, medical therapy has provided only minimal benefits for OPCA. No medications are actually approved by the FDA for use in this condition. The medications mentioned here may be helpful in certain patients. Physicians should not prescribe these for OPCA unless they are familiar with the contraindications, interactions, precautions, and other potential problems and unless they discuss these with their patients. Brief summaries are listed, but more detail is provided in the package insert and in the literature.

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Dopaminergic agents

Class Summary

Used to improve parkinsonian and tremor-related symptoms.

Levodopa/carbidopa (Sinemet)

Direct dopaminergic agent. Carbidopa prevents peripheral decarboxylation of levodopa, thus facilitating entry into CNS. Comes in different strengths of 25/100 mg, 25/250 mg, and 10/100 mg.

Amantadine (Symmetrel)

Unknown mechanism of action; may release dopamine from remaining dopaminergic terminals in Parkinson patients or from other central sites. Less effective than levodopa in treating Parkinson disease; slightly more effective than anticholinergic agents.

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Antihypertensive agents

Class Summary

For OPCA, propranolol is used to help reduce the tremor. As with all medication, this pharmacologic therapy should be individualized based on a patient's age, race, known pathophysiologic variables, and concurrent conditions. The usual use of propranolol is to lower blood pressure and help ameliorate left ventricular hypertrophy. It can precipitate congestive heart failure, cause or worsen hyperlipidemia, worsen or precipitate asthma/COPD attacks, and mask hypoglycemia in diabetes. See the package insert for other precautions, interactions, and contraindications.

Propranolol (Inderal, Betachron E-R)

Nonselective beta-adrenergic agonist; mechanism of action for tremor suppression not fully known.

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Antianxiety Agent

Class Summary

A modest improvement in ataxia has been observed in a few small clinical trials. One study showed no benefits. Another study showed benefits that were not sustained beyond 3 months.

Bupropion (Wellbutrin, Zyban)

Bupropion inhibits neuronal dopamine reuptake in addition to being a weak blocker of serotonin and norepinephrine reuptake.

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