Talk:Apomorphine

Untitled

I think that the chemical structure image is an optical isomer of apomorphine. Not a chemist though, could do with being looked at maybe. Apomorphine as opposed to 4H-dibenzo[de,g]quinoline-10,1​1-diol, 5,6,6a,7-tetrahydro-6-​methyl-, (6aS)- —Preceding unsigned comment added by 130.88.99.232 (talk) 14:02, 7 January 2011 (UTC)

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Medical Uses update

Hi editors, I'm Lexi and I'm a physician with Supernus Pharmaceuticals, which manufactures apomorphine.

I believe that the Medical uses section is inconsistent with rules for medical content sourcing and the Pharmacology style guide. Its focus on the historical is also likely to be confusing for modern patients researching the drug. To resolve this, I propose updating the section to stay focused on current uses and best practice guidelines for apomorphine. Here's what I propose:

Apomorphine is used for the management of motor fluctuations in Parkinson's disease, particularly for the treatment of "off" episodes. "Off" episodes are periods during which motor symptoms such as rigidity, bradykinesia, or reduced mobility reemerge as the effects of dopaminergic medications wear off. Apomorphine can provide rapid improvement in motor symptoms.

Apomorphine is administered in multiple pharmaceutical formulations. Intermittent subcutaneous injection is used as an acute treatment and has been shown to terminate "off" episodes in individuals with motor fluctuations not adequately controlled with oral therapy. Sublingual formulations have also been shown to be effective as acute treatments of "off" episodes.

Continuous subcutaneous infusion of apomorphine using a wearable infusion device is also prescribed for individuals with motor fluctuations. Continuous infusion treatment is used in patients whose symptoms are not adequately controlled with oral or transdermal therapies and has been shown to reduce daily "off" time. Apomorphine is generally used as an adjunct to levodopa-based therapy in patients with Parkinson's disease and motor fluctuations.

References

Please let me know what you think! Happy to answer any questions. Lexi at Supernus (talk) 20:50, 29 April 2026 (UTC)

I added a section Modern medical usage using your text, please let me know, if it's in the right place. Victoria (talk) 11:54, 18 May 2026 (UTC)

Your edit summary doesn't have any attribution (a link to the talk page: special:diff/1351737559). You had to specify a link and the information on whether the content was modified. Take a look at Wikipedia:Copying within Wikipedia, Wikipedia:Copyrights and Wikipedia:Plagiarism. D6194c-1cc (talk) 15:44, 18 May 2026 (UTC)

@Victoria: Thanks for doing that! I was thinking that this would replace the Apomorphine#Medical_uses section at the top, since this information is the most up to date and the current Medical uses section might cause confusion for patients. What do you think about moving the content to that top section? Lexi at Supernus (talk) 13:46, 19 May 2026 (UTC)

Done. Victoria (talk) 08:54, 21 May 2026 (UTC)

Lexi at Supernus, would you be so kind to declare here that you license the provided text under the CC0 license? Currently, the text is provided via the CC BY-SA 4.0 license. Such a way there would be no inconsistency between Victoria's edit, the license, and the rules of the English Wikipedia. D6194c-1cc (talk) 21:17, 19 May 2026 (UTC)

@D6194c-1cc: Sure, I declare it is CC0 licensed. I am not entirely sure how the licensing works. Lexi at Supernus (talk) 22:38, 21 May 2026 (UTC)

Thanks! Under the CC0 license, mentioning the original author is not necessary. So if you'd want to backup up the editor who will copy some new content to an article in the future, you can simply add a note that you license the content under the CC0 license. For a company, authorship is not important, as I understand. D6194c-1cc (talk) 05:38, 22 May 2026 (UTC)

@Victoria: I think there may be some confusion about the placement of the content, so I will try to reframe:

I propose removing the content currently in Apomorphine#Medical_uses, which is as follows:

=== Parkinson's disease ===

The use of apomorphine to treat "the shakes" was first suggested by Weil in France in 1884, although seemingly not pursued until 1951. Its clinical use was first reported in 1970 by Cotzias et al., although its emetic properties and short half-life made oral use impractical. A later study found that combining the drug with the antiemetic domperidone improved results significantly. The commercialization of apomorphine for Parkinson's disease followed its successful use in patients with refractory motor fluctuations using intermittent rescue injections and continuous infusions. Apomorphine is used in advanced Parkinson's disease intermittent hypomobility ("off" episodes), where a decreased response to an anti-Parkinson drug such as L-DOPA causes muscle stiffness and loss of muscle control. While apomorphine can be used in combination with L-DOPA, the intention is usually to reduce the L-DOPA dosing, as by this stage the patient often has many of dyskinesias caused by L-DOPA and hypermobility periods. When an episode sets in, the apomorphine is injected subcutaneously or applied sublingually, and signs subside. It is used an average of three times a day. Some people use portable mini-pumps that continuously infuse them with apomorphine, allowing them to stay in the "on" state and using apomorphine as an effective monotherapy.

References

I propose removing the heading Modern medical uses from the article, and placing the content under that heading under the Medical uses heading at the top of the article. That content would be as follows:

Medical uses

Apomorphine is used for the management of motor fluctuations in Parkinson's disease, particularly for the treatment of "off" episodes. "Off" episodes are periods during which motor symptoms such as rigidity, bradykinesia, or reduced mobility reemerge as the effects of dopaminergic medications wear off. Apomorphine can provide rapid improvement in motor symptoms.

Apomorphine is administered in multiple pharmaceutical formulations. Intermittent subcutaneous injection is used as an acute treatment and has been shown to terminate "off" episodes in individuals with motor fluctuations not adequately controlled with oral therapy. Sublingual formulations have also been shown to be effective as acute treatments of "off" episodes.

Continuous subcutaneous infusion of apomorphine using a wearable infusion device is also prescribed for individuals with motor fluctuations. Continuous infusion treatment is used in patients whose symptoms are not adequately controlled with oral or transdermal therapies and has been shown to reduce daily "off" time. Apomorphine is generally used as an adjunct to levodopa-based therapy in patients with Parkinson's disease and motor fluctuations.

References

}}

This should ensure readers do not confuse old usages with how it is currently used and makes it more consistent with the rules for medical content sourcing and the Pharmacology style guideline. Hopefully that makes sense! Lexi at Supernus (talk) 22:38, 21 May 2026 (UTC)

Lexi at Supernus Per WP:MEDRS The sentence “Apomorphine can provide rapid improvement in motor symptoms” cites the Olanow phase 3 trial (a primary source). I suggest replacing this source with the Chen (review) and Trenkwalder (expert consensus). The sentence “Sublingual formulations have also been shown to be effective…” cites Agbo PK/bioavailability RCT (primary). I suggest replacing with Fox (MDS evidence‑based review). Boghog (talk) 15:25, 16 June 2026 (UTC)

After replacing primary with secondary source, the content that you propose reads as neutral and encyclopedic and does not show obvious signs of being slanted toward Supernus. Hence I would support replacing the current "Medical uses" section with the one that you are proposing. Boghog (talk) 15:53, 16 June 2026 (UTC)

@Boghog: thank you for the close eye! I have replaced the Olanow study as you suggested but I couldn't see in Fox where it mentioned the sublingual formulations. I was able to find another review that does state the same claim, so I replaced it with that. What do you think?

In think the PMID 38743091 citation is appropriate to include. The citation I was referring to was PMID 40055961 which does mention "sublingual film". The two review come to somewhat different conclusions however which could be summarized as follows:

Sublingual apomorphine film has been reported ins a recent narrative review to produce rapid OFF‑to‑ON conversion and clinically meaningful short‑term improvements in motor scores when used as an on‑demand treatment for OFF episodes in Parkinson’s disease PMID 38743091, but an MDS evidence‑based review judged the randomized‑trial data insufficient to conclude that intermittent apomorphine formulations (including sublingual film) provide sustained benefits in disability or quality of life over 12‑week treatment periods.PMID 40055961 Boghog (talk) 04:59, 19 June 2026 (UTC)

Apomorphine is used for the management of motor fluctuations in Parkinson's disease, particularly for the treatment of "off" episodes. "Off" episodes are periods during which motor symptoms such as rigidity, bradykinesia, or reduced mobility reemerge as the effects of dopaminergic medications wear off. Apomorphine can provide rapid improvement in motor symptoms.

Apomorphine is administered in multiple pharmaceutical formulations. Intermittent subcutaneous injection is used as an acute treatment and has been shown to terminate "off" episodes in individuals with motor fluctuations not adequately controlled with oral therapy. Sublingual formulations have also been shown to be effective as acute treatments of "off" episodes.

Continuous subcutaneous infusion of apomorphine using a wearable infusion device is also prescribed for individuals with motor fluctuations. Continuous infusion treatment is used in patients whose symptoms are not adequately controlled with oral or transdermal therapies and has been shown to reduce daily "off" time. Apomorphine is generally used as an adjunct to levodopa-based therapy in patients with Parkinson's disease and motor fluctuations.

References

Thanks again for looking! Lexi at Supernus (talk) 12:49, 18 June 2026 (UTC)

@Boghog: That works for me if it works for you! I have put it together all in one block of markup:

Apomorphine is used for the management of motor fluctuations in Parkinson's disease, particularly for the treatment of "off" episodes. "Off" episodes are periods during which motor symptoms such as rigidity, bradykinesia, or reduced mobility reemerge as the effects of dopaminergic medications wear off. Apomorphine can provide rapid improvement in motor symptoms.

Apomorphine is administered in multiple pharmaceutical formulations. Intermittent subcutaneous injection is used as an acute treatment and has been shown to terminate "off" episodes in individuals with motor fluctuations not adequately controlled with oral therapy. Sublingual apomorphine film has been reported in a recent narrative review to produce rapid off‑to‑on conversion and clinically meaningful short‑term improvements in motor scores when used as an on‑demand treatment for off episodes in Parkinson's disease, but an MDS evidence‑based review judged the randomized‑trial data insufficient to conclude that intermittent apomorphine formulations (including sublingual film) provide sustained benefits in disability or quality of life over 12‑week treatment periods.

Continuous subcutaneous infusion of apomorphine using a wearable infusion device is also prescribed for individuals with motor fluctuations. Continuous infusion treatment is used in patients whose symptoms are not adequately controlled with oral or transdermal therapies and has been shown to reduce daily "off" time. Apomorphine is generally used as an adjunct to levodopa-based therapy in patients with Parkinson's disease and motor fluctuations.

References

What do you think? Lexi at Supernus (talk) 18:43, 24 June 2026 (UTC)

@Lexi at Supernus: Looks good. Implemented in this edit. I hope this is OK. Cheers. Boghog (talk) 10:44, 25 June 2026 (UTC)

@Boghog: looks great! Thanks for your time reviewing! Lexi at Supernus (talk) 19:56, 25 June 2026 (UTC)

Your edit misses the sufficient attribution, see special:PermanentLink/1355499736#Medical_Uses_update for details. D6194c-1cc (talk) 09:00, 19 July 2026 (UTC)

Side effects update

Hi editors, Lexi with Supernus Pharmaceuticals again with a request to update the side effects section. The current section uses some, from what I understand, questionable sources (drugs.com), and it is missing some potential side effects, so I propose the following which uses peer-reviewed literature and the FDA label to list out the side effects.

Common side effects of apomorphine include nausea and vomiting, particularly when starting treatment; injection site reactions, including bruising, subcutaneous nodules, and rarely necrosis or abscesses; somnolence, dizziness, and falls. Clinical reviews note that while nausea is frequently reported early during apomorphine therapy, tolerability may improve with a lower starting dose and continued use, and routine antiemetic pretreatment is not universally required.

Less common side effects include dyskinesia, orthostatic hypotension, hallucinations or psychotic-like behavior, syncope, hemolytic anemia, impulse control disorders, dose-dependent QT interval prolongation, peripheral edema, and priapism.

References

Please let me know what you think! Lexi at Supernus (talk) 20:01, 25 June 2026 (UTC)

"not universally required" is peacock language. So is " shown to reduce" without numbers (prev. edit) . [edit: In other words, the language doesn't convey a NPOV. See also: MOS:WEASEL.] RememberOrwell (talk) 08:58, 11 July 2026 (UTC)

The "shown to" language would be better off just getting to the point: it reduces, it is effective, etc. But it's not WP:PEACOCK, and we don't require numbers. WhatamIdoing (talk) 22:25, 4 August 2026 (UTC)

Your reading comprehension needs work? Who said what was peacock, exactly? Taking something someone said out of context and then commenting on what's wrong with it because it's out of context ... is disruptive. RememberOrwell (talk) 06:54, 14 August 2026 (UTC)

Did you see my reply at https://en.wikipedia.org/wiki/Wikipedia:Village_pump_(policy)/Archive_214#c-RememberOrwell-20260731013700-WhatamIdoing-20260729205100 ? You never replied. RememberOrwell (talk) 14:47, 14 August 2026 (UTC)

I'm only familiar with apomorphine in veterinary medicine and I have never seen any of those side effects besides somnolence and dizziness. I presume these side effects are from continued use and do not occur with the first dose, in which case it'd be good to highlight that, even if short/single dose apomorphine is not currently used in human medicine. Traumnovelle (talk) 01:49, 29 July 2026 (UTC)

@Traumnovelle: that's a reasonable assumption but every patient is different. Any of these side effects could be experienced on the first dose. Vomiting and nausea are especially common early in treatment. The research and labels track general incidence, not when during the course of treatment the side effect first occurs. Would adding a note that these are side effects for humans alleviate your concerns? The Veterinary use section already covers that the drug is used to induce vomiting in dogs and is not effective for cats.

@RememberOrwell: I am not sure what you mean by peacock language. I think you are referring to Wikipedia:Manual_of_Style/Words_to_watch#Puffery? I am not sure how saying "not universally required" meets that standard. But in any case, perhaps it's clearer to only mention the side effects and leave how they are treated out. Lexi at Supernus (talk) 13:10, 5 August 2026 (UTC)

Sorry, I didn't really consider emesis/nausea a side effect. The cardiac issues are something one would expect to only come about with repeated dosing as opposed to a one-off dose. One of the sources indicates continuous subcutaneous administration results in more adverse effects than intermittent injections. Traumnovelle (talk) 20:50, 5 August 2026 (UTC)

@Traumnovelle: no worries! I think it's reasonable to expect the cardiac effects would come about from more long-term dosing but we have seen them occur at all stages of treatment. I am trying to stick really closely to what the sourcing says and it doesn't make that distinction. I think making claims like that in the article would get into the territory of original research based on my reading of that policy and I don't want to run into any issues with that. You are right that the Carbone 2019 source says adverse effects may be more common with continuous injection. I can add a sentence about that if you like? Lexi at Supernus (talk) 00:25, 11 August 2026 (UTC)

Yes, I think that would be an improvement. And yes, we do have to stick to the sources and sometimes sources neglect the glaringly obvious. Traumnovelle (talk) 03:58, 11 August 2026 (UTC)

@Traumnovelle: They sometimes do indeed. What do you think about this?

Common side effects of apomorphine include nausea and vomiting, particularly when starting treatment; injection site reactions, including bruising, subcutaneous nodules, and rarely necrosis or abscesses; somnolence, dizziness, and falls. Clinical reviews note that while nausea is frequently reported early during apomorphine therapy, tolerability may improve with a lower starting dose and continued use.

Less common side effects include dyskinesia, orthostatic hypotension, hallucinations or psychotic-like behavior, syncope, hemolytic anemia, impulse control disorders, dose-dependent QT interval prolongation, peripheral edema, and priapism. Adverse effects are more common with continuous subcutaneous apomorphine infusion than intermittent treatment.

References

That should cover the concern from RememberOrwell as well. Thanks for looking! Lexi at Supernus (talk) 21:10, 13 August 2026 (UTC)

That is good. Traumnovelle (talk) 22:57, 13 August 2026 (UTC)

N What comes before the first '.' isn't quite a proper English sentence. It has bad grammar. Two verbs are needed.

Replace the peacock language of "routine antiemetic pretreatment is not universally required" ; see MOS:WEASEL, WP:NPOV. Tell us, antiemetic pretreatment is routine? concurrent treatment is routine? If so say so. {{Peacock}} displays: . In other words, the language that I flagged, in context, doesn't convey a NPOV. A paid editor shouldn't need to be spoon-fed policy. "No editor should be expected to engage in long or repetitive discussions with someone who is being paid to argue with them." - WP:PAYTALK RememberOrwell (talk) 06:48, 14 August 2026 (UTC)

@RememberOrwell: I promise I was not trying to be obtuse here, I was trying to understand your interpretation of that rule and square it with what the sourcing says.

Regardless, I had removed that phrase from the subsequent suggested text, which is what that banner says to do.

As far as the sentence before the first period, I assume you mean this one: "Common side effects of apomorphine include nausea and vomiting, particularly when starting treatment; injection site reactions, including bruising, subcutaneous nodules, and rarely necrosis or abscesses; somnolence, dizziness, and falls." Would it be helpful to break it up into two sentences?

• Common side effects of apomorphine include nausea and vomiting, particularly when starting treatment, and injection site reactions, including bruising, subcutaneous nodules, and rarely necrosis or abscesses. Other common side effects include somnolence, dizziness, and falls.

Let me know what you think of that. Lexi at Supernus (talk) 12:37, 18 August 2026 (UTC)

@Traumnovelle: it looks like RememberOrwell has been blocked. I don't want to make any changes unless I am absolutely certain I've got volunteer go-ahead here and I don't think they will be coming back to the conversation, so would you be willing to take a last look here? I appreciate all your time and attention here. Lexi at Supernus (talk) 18:14, 26 August 2026 (UTC)

I don't have an issue with the text. RememberOrwell was ban evading so any edits he has made are considered invalid/null because he should not have been participating, so you can ignore them. Traumnovelle (talk) 20:17, 26 August 2026 (UTC)

@Traumnovelle: Sounds good! I made the change in the article, let me know if there is anything there that looks weird but I think it should be good to go. I appreciate your willingness to look things over! Lexi at Supernus (talk) 23:38, 3 September 2026 (UTC)

Contraindications

Hi editors, I wanted to propose an update to the Contraindications section. As it is now, the section is incomplete and relies heavily on a source that I don't think meets reliability standards for medical articles (drugs.com).

Here's what I propose which is supported by the FDA documentation on the drug:

Apomorphine is contraindicated when used concomitantly with serotonin 5-HT₃ receptor antagonists, including ondansetron, granisetron, and palonosetron, as this combination has been associated with profound hypotension and loss of consciousness. It is also contraindicated with allergies to the drug or its excipients, including sulfites. Intravenous administration of apomorphine is associated with blood clots and pulmonary embolism due to crystallization in the vein and is not recommended.

References

Please let me know what you think. @Traumnovelle: pinging you in case you have any interest in taking a look at this update as well! Thanks! Lexi at Supernus (talk) 13:58, 10 September 2026 (UTC)

I'm only familiar with apomorphine in animals. We use it as a pro-emetic and use maropitant to cancel or 'reverse' (not a true reversal) the emesis it causes. Some further information on the mechanism would be good but the FDA does not cite anything for the contraindication. We do give IV apomorphine in animals (tablet dissolved in 0.9% saline) without issue, so I wonder if the crystallisation is due to the specific formulation?

this appears to be the clinical study that discovered the risk of IV apomorphine in people, perhaps the risk is due to the continuous infusion as opposed to the small bolus that is used in veterinary medicine.

There is no issue with the edit from a COI stand point so feel free to add it. Traumnovelle (talk) 20:19, 10 September 2026 (UTC)

@Traumnovelle: I don't see anything there for the mechanism either. I couldn't say why the risk of crystallization is different for animals, it could be formulation or physiological differences, could be continuous infusion. My background is in human medicine so I can only offer limited insight into animal medicine. I appreciate you taking a look though! I have made the updates, let me know if everything looks okay, I think it should be good though. Lexi at Supernus (talk) 15:52, 1 October 2026 (UTC)

Historical Medical Uses

Hi editors, I have a bit of a complicated request. In short, I believe the Historical medical uses section is likely at odds with several policies about biomedical information and neutrality. In its current form, I also think it could be construed as giving medical advice and as such it should be revised ASAP to avoid those appearances for reader safety.

I propose rewriting the section. I'll go piece by piece:

Introductory paragraphs:

Extended content

Old paragraphs

The pharmacological effects of the naturally occurring analog aporphine in the blue lotus (Nymphaea caerulea) were known to the ancient Egyptians and Mayans, with the plant featuring in tomb frescoes and associated with entheogenic rites.

The modern medical history of apomorphine begins with its synthesis by Arppe in 1845 from morphine and sulfuric acid, although it was named sulphomorphide at first. Matthiesen and Wright (1869) used hydrochloric acid instead of sulfuric acid in the process, naming the resulting compound apomorphine. Initial interest in the compound was as an emetic, tested and confirmed safe by London doctor Samuel Gee, and for the treatment of stereotypies in farmyard animals. Key to the use of apomorphine as a behavioural modifier was the research of Erich Harnack, whose experiments in rabbits (which do not vomit) demonstrated that apomorphine had powerful effects on the activity of rabbits, inducing licking, gnawing and in very high doses convulsions and death.

References

New paragraphs

The pharmacological effects of the naturally occurring analog aporphine in the blue lotus (Nymphaea caerulea) were known to the ancient Egyptians and Mayans, with the plant featuring in tomb frescoes and associated with entheogenic rites.

Apomorphine was first chemically synthesized by Adolf Edvard Arppe in 1845 from morphine and sulfuric acid. Augustus Matthiessen and Charles Romley Alder Wright synthesized apomorphine from morphine and hydrochloric acid in 1869.

The drug was the subject of investigations by Samuel Gee, Erich Harnack, and Vincent Siebert in the 1860s and 1870s. Gee found a range of physiological effects in various animals, including stereotypies, excitement, vomiting, and epileptic convulsions; his findings were later confirmed by Harnack and Siebert. Harnack hypothesized it may have had effects less pronounced than emesis, and animal testing showed effects including on motor control and other functions, concluding that the drug affected multiple areas of the brain. Further animal experiments that included removing the medulla oblongata and otherwise targeting specific areas of the brain with the drug to produce particular effects allowed researchers to narrow the areas which the drug affected. Anton Marie Ernst later determined in a 1967 study that apomorphine affected dopaminergic receptors in the brain.

References

Problems:

• Unsourced content is present e.g.:
  • Matthiesen and Wright (1869) used hydrochloric acid instead of sulfuric acid in the process, naming the resulting compound apomorphine.
  • Key to the use of apomorphine as a behavioural modifier was the research of Erich Harnack, whose experiments in rabbits (which do not vomit) demonstrated that apomorphine had powerful effects on the activity of rabbits, inducing licking, gnawing and in very high doses convulsions and death.
• Lack of specificity in writing (Who is Arppe? Who are Wright and Matthiesen?)
• Sourcing doesn't say Gee's interest in apomorphine was as an emetic, it seems to me reading the proceedings that he was collecting an array of data, not just on emesis but on all the effects apomorphine was having (Gee's original report from 1869 can be found on Wikimedia Commons, printed p. 166, digital page 205)
  • Subsequent scholarship says the drug's "most salient" characteristic was emesis, but that Gee recorded other effects as well
• Section as a whole is missing key discovery of apomorphine's dopaminergic effects and other early experimentation

My proposed paragraphs:

• Remove unsourced content
• Clarify which scientists were involved in research and in what ways
• Clarify Gee's research
• Add missing information on dopaminergic discovery and other early experiments
  • Note: Ernst's experiments are mentioned later in the section, but incorrectly. The 1965 experiment found apomorphine had a structure similar to dopamine; the 1967 experiment found that it stimulated dopaminergic receptors. Similar, but different
• Makes the timeline more consistent

Treatment of alcoholism, Aversion therapy, and Opioid addiction:

Omitting text of subsections due to length concerns, here is my proposed replacement:

Extended content

Apomorphine was heavily researched by the time of Ernst's study and had been used as an emetic in veterinary applications. In humans, the drug was used to treat a variety of maladies, including to induce vomiting in cases of poisoning, to relieve bronchitis and other respiratory illnesses, as an aversive conditioner in substance abuse treatment, to quell mania or anxiety, to treat erectile dysfunction, and to treat various movement disorders, among others. There are conflicting studies about the drug's efficacy in treating addiction.

Apomorphine was first suggested as a treatment for Parkinson's disease in 1884 by Edmond Weill, but it received limited interest from the scientific community until the late 1980s, when it was found to be a valuable therapy to be used alongside levodopa and related drugs.

Apomorphine has been researched as a possible treatment for erectile dysfunction and female hypoactive sexual desire disorder, though its efficacy has been limited.

References

Problems with the current text:

• Missing other historical uses of apomorphine
• Excessive reliance on quotations at odds with the manual of style
• Excessive detail on treatment methods, down to specific dosing information, amounts, and timing to treat substance abuse
  • Nowhere in the world is apomorphine approved for treating substance abuse, though it was once something tried by doctors
  • The level of detail in these sections strikes me as undue weight being given to what were essentially fringe theories for treating substance abuse, theories, which, again, are not accepted today and even at the time were not widely accepted. This content is vastly longer than all the other sections of the article combined
  • The level of detail also strikes me as potentially giving instructions for how to treat substance abuse with apomorphine, which does not align with Wikipedia not being an instruction manual. It is very possible to discuss these topics without this kind of detailed dosing information that edges into medical advice
• The section on opioid addiction is sourced to an unreliable source (RealityStudio) and to William Burroughs, who, notably, was not a doctor or scientist, and who fell back into substance abuse not long after his claimed "cure" with apomorphine. I think this is dangerously misleading to readers and does not meet WP:MEDRS guidelines
• It says there is "renewed interest" in apomorphine for smoking cessation and treatment of alcoholism
  • The alcoholism source is apomorphine.info, which is not a reliable source
  • There were two reviews, one of which I cite in my revised paragraphs, that I can find that mention the potential of apomorphine for smoking cessation from the last 15 years. This is a fringe theory and not something being actively explored to any major degree. I don't think this should be included in the article

My proposed paragraphs solve these issues by:

• Dramatically shrinking the content so it does not dwarf the rest of the article
• Removing all quotations, especially those that could be considered to be giving medical advice
• Adding the missing past uses of the drug
• Removal of mention of William Burroughs and opioid addiction as there is not a reliable source discussing this
  • Even if we count the foreword of Burroughs' book as a source for his opinion, I still don't think we should include this in the article, it was a pretty out there fringe theory even for the time
• Removes the "renewed interest" due to poor sourcing and a lack of real support

Related to these above changes, I would also suggest removing the last paragraph of the introduction, which repeats much of the same bunk science. The study cited in the introduction about the apomorphine test also doesn't have any significant follow-ups and is low on the hierarchy of medical evidence.

I know that's a lot, please let me know what you think/if you have questions/if I should break it down another way. Thanks! Lexi at Supernus (talk) 15:56, 1 October 2026 (UTC)

I haven't read all of this but WP:MEDRS does not apply to historical information, as long as it is clearly indicated as such. Traumnovelle (talk) 19:32, 1 October 2026 (UTC)