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Rationale for current therapies in Parkinson's disease
Janet Romrell1, Hubert H Fernandez, Michael S Okun
1University of Florida, Department of Neurology, McKnight Brain Institute, PO Box 100236, Gainesville, FL 32610, USA.
Expert Opinion on Pharmacotherapy
|October 3, 2003
Summary
Medication advances have improved Parkinson's disease (PD) management, with levodopa still key. New strategies, including dopamine agonists and antipsychotics, offer better quality of life, though unmet needs remain.
Area of Science:
- Neurology
- Pharmacology
Background:
- Parkinson's disease (PD) affects millions globally, with significant advancements in medication therapy over the past decade.
- Current treatments aim to improve the quality of life for individuals with PD.
Purpose of the Study:
- To review the rationale and strategies for current medical therapies in Parkinson's disease.
- To emphasize the use of antipsychotic agents in PD management.
Main Methods:
- Review of current medical therapies for Parkinson's disease.
- Emphasis on the role of antipsychotic agents in conjunction with dopaminergic therapies.
Main Results:
- Levodopa is the most effective PD medication, but long-term use can cause motor fluctuations like dyskinesia.
- Dopamine agonists may delay dyskinesia onset and are being investigated for neuroprotective effects.
- Anticholinergics, COMT inhibitors, MAO-B inhibitors, amantadine, and selective dopamine blockers (e.g., clozaril, quetiapine) offer symptomatic relief and manage psychosis.
Conclusions:
- Significant progress has been made in symptomatic management of Parkinson's disease.
- Combination therapy, including selective dopamine blockers for psychosis, improves patient outcomes.
- Despite advances, there are still unmet needs in Parkinson's disease treatment.