Current drug therapy for Parkinson's disease. A review

The impact of neuropharmacology has been greatest in 2 areas of clinical treatment: epilepsy and Parkinson's disease. This article covers the drug treatment of Parkinson's disease, a condition which characteristically affects the elderly population. The 5 drugs or groups of drugs used in the treatment of Parkinson's disease are: (a) anticholinergic drugs; (b) amantadine; (c) levodopa plus a peripheral decarboxylase inhibitor; (d) dopamine agonists; and (e) selegiline. Levodopa is still the most effective anti-Parkinsonian drug for most patients and is often combined with selegiline which may retard the rate of disease progression. The early use of dopamine agonists (such as bromocriptine) may prevent the subsequent development of response fluctuations. Once fluctuations have developed, they may be helped by the use of slow release levodopa preparations and, in the most severe cases, subcutaneous apomorphine.