Pergolide

Pergolide is an ergot-derived dopamine agonist that acts primarily on dopamine D2 receptors in the brain. It was developed for the treatment of Parkinson's disease and was marketed widely under the brand name Permax. In clinical use, it was prescribed to improve motor symptoms, often in the early to mid stages of the disease or as an adjunct to other therapies.

Regulatory and safety history has been marked by concerns over heart safety. In 2003, pergolide was withdrawn from the United States market after accumulating evidence that long-term pergolide use was associated with valvular heart disease, including valvular regurgitation and heart failure. Similar concerns led to regulatory actions in other jurisdictions. Because of these safety findings, pergolide is no longer approved for human use in many markets, and clinicians generally avoid it for Parkinson's disease in favor of alternatives with different risk profiles.

Adverse effects associated with pergolide in humans include nausea, dizziness, orthostatic symptoms, and neuropsychiatric effects; more serious concerns center on cardiovascular toxicity. The risk of valvular heart disease has been a major factor in regulatory decisions and monitoring recommendations.

In veterinary medicine, pergolide mesylate remains approved in many countries for horses to treat equine Cushing's disease (pituitary pars intermedia dysfunction). It is marketed under various brand names and is dosed and monitored according to veterinary guidelines.