What is the recommended dosage of lesuride (lysergide) in milligrams (mg) for adults?

Lisuride Dosing in Adults

Lisuride is not a standard medication with established dosing guidelines for routine clinical use, and the available evidence is extremely limited and of very low quality, consisting only of small, decades-old studies in Parkinson's disease showing doses of 0.8-4.8 mg daily orally or 0.05-0.15 mg intravenously, with significant neuropsychiatric adverse effects. 1

Critical Context: Limited Evidence Base

The question appears to reference "lesuride," but the only relevant medication in the medical literature is lisuride, an ergoline derivative dopamine agonist that was studied primarily in the 1980s for Parkinson's disease. The evidence base is extremely sparse:

• Only one relevant study from 1981 examined lisuride dosing in 9 patients with parkinsonism 1
• The medication appears in a 2020 alcohol dependence network meta-analysis, but with very low quality evidence from a single small trial (n=57) showing no benefit for alcohol abstinence 2
• No modern guidelines, FDA approval, or contemporary clinical trials support its use 2, 1

Historical Dosing from Parkinson's Disease Studies

Intravenous Administration

• Dose range: 0.05-0.15 mg IV 1
• Onset: Immediate improvement in tremor, rigidity, akinesia, and postural deformity 1
• Duration of effect: 2-3 hours 1
• Adverse effects: Chorea and orofacial dyskinesia occurred with IV administration 1

Oral Administration

• Dose range: 0.8-4.8 mg daily 1
• Effects: Similar therapeutic benefits to IV administration but with concerning neuropsychiatric side effects 1
• Significant adverse effects: Reduced awareness and hallucinations occurred occasionally with oral therapy 1

Safety Concerns and Clinical Implications

The neuropsychiatric adverse effect profile makes lisuride unsuitable for routine clinical use:

• Hallucinations and reduced awareness were documented even at therapeutic doses 1
• Movement disorders (chorea, orofacial dyskinesia) occurred with treatment 1
• The medication showed minimal or no effect in conditions beyond Parkinson's disease 1

Evidence Quality Assessment

The evidence for lisuride is of very low quality across all available sources:

• The alcohol dependence meta-analysis rated lisuride evidence as "very low quality" with only 57 participants in a single trial 2
• The only dosing data comes from a 1981 case series of 9 patients, which represents the lowest tier of clinical evidence 1
• No contemporary randomized controlled trials, systematic reviews, or guideline recommendations exist for this medication 2, 1

Clinical Recommendation

Lisuride should not be used in modern clinical practice. If the question pertains to a different medication with a similar name, clarification is needed. For Parkinson's disease, contemporary dopamine agonists with established safety profiles and robust evidence bases (such as pramipexole or ropinirole) should be used instead. For alcohol dependence, acamprosate has moderate-quality evidence supporting its use at standard doses 2.