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Rating L-DOPA-Induced Dyskinesias in the Unilaterally 6-OHDA-Lesioned Rat Model of Parkinson's Disease
Published on: October 4, 2021
Emerging drugs for autonomic dysfunction in Parkinson's disease
Santiago Perez-Lloret1, María Verónica Rey, Anne Pavy-Le Traon
1University of Toulouse III, University Hospital, Department of Clinical Pharmacology and Neuroscience, Toulouse, France. splloret@fleni.org.ar
Expert Opinion on Emerging Drugs
|February 5, 2013
Summary
Treatments for Parkinson's disease (PD) autonomic dysfunction are limited, with few clinical trials. Emerging therapies show promise for conditions like orthostatic hypotension and constipation, but more research is needed.
Area of Science:
- Neurology
- Pharmacology
Background:
- Autonomic dysfunction is prevalent in Parkinson's disease (PD), encompassing orthostatic hypotension (OH), sialorrhea, sexual dysfunction, urinary issues, and constipation.
- Effective treatments for PD autonomic dysfunction are a significant unmet need, yet clinical trials remain scarce.
Purpose of the Study:
- To review current evidence on the efficacy and safety of treatments for autonomic dysfunction in Parkinson's disease.
- To explore potential therapeutic targets and discuss ongoing clinical trials for these conditions.
Main Methods:
- Summarized evidence on available treatments for autonomic dysfunction in PD.
- Discussed physiopathology-based potential targets and proof-of-concept trial data.
- Considered critical aspects of clinical trial design for future studies.
Main Results:
- Botulinum toxin (BTX) or glycopyrrolate for sialorrhea; macrogol for constipation.
- Preliminary evidence supports fludrocortisone, domperidone, droxidopa, or fipamezole for OH.
- Sildenafil for erectile dysfunction; BTX or behavioral therapy for urinary incontinence; lubiprostone and probiotics for constipation.
Conclusions:
- Several treatments show potential for specific autonomic dysfunctions in PD, including OH, sialorrhea, constipation, sexual, and urinary dysfunction.
- Emerging therapies like tropicamide, clonidine, and radiotherapy are under development for sialorrhea.
- Robust clinical trials are essential to establish evidence-based recommendations for treating autonomic dysfunction in Parkinson's disease.
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