Titan Pharmaceuticals Inc (TTNP)

[KMBJN]

There is high variability of anti-parkinsonian prescribing patterns across physicians, and across countries, without any standard practice. Some hold off on levodopa (and start with dopamine agonsists) due to levodopa-induced-dyskinesias. Some like to use dopamine agonists in general, while others do not - perhaps due to some of the compulsive behavior type side effects (gambling, OCD, hypersexuality, etc...) . Some use rasagaline (Azilect), others do not.

Anyways, I don't get/pay for the drug prescribing information that is out there. I saw a few papers on prescribing patterns for PD, from Europe 2003-2007:
https://www.ncbi.nlm.nih.gov/pubmed/20222132
and US 2001-2012 inpatients:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500853/

In Europe in 2007, pramipexole was more popular (by sales $) than ropinirole. In US inpatients, use now about equal. Nobody really uses apomorphine, since it required injection (and used mostly for off / freezing episodes). Now have Cynapsus' sublingual apomorphine in trials, and will be used more for freezing episodes. Perhaps some might try to use it like a pill, but I think probably not, since it has a relatively short half-life.

Not sure about all the nuances about the differences in dopamine agonists. Some activate dopamine D2, D3, and other subtypes in different proportions / affinities. Here's a review of dopamine receptor subtypes and dopamine agonists:

https://www.hindawi.com/journals/ijmc/2011/403039/