Relating mode of action to clinical practice: dopaminergic agents in Parkinson's disease

Most treatment advances in PD have been based on restoring dopaminergic input. The development of levodopa was the first breakthrough and, since then, other compounds have been developed. Each antiparkinsonian medication has its own profile of efficacy and adverse effects, and these can largely be explained by their modes of action. As patients receive a number of different compounds, physicians should be aware of the differences of agents and understand how these differences may relate to clinical practice. This article reviews the three main classes of dopaminergic PD therapy (levodopa, monoamine oxidase inhibitors and dopamine agonists).