[Treatment of end-of-dose fluctuations: the need for an individualized approach]

Patients with Parkinson's disease show a wide heterogeneity of symptoms and comorbidities, requiring individualized therapeutic strategies, particularly in advanced stages of the disease. This is reflected by the choice of different substance classes and drugs for the treatment of end-of-dose fluctuations. Each of these drugs offers a characteristic profile of effects and unwanted side-effects, which has to be taken into consideration. Replacement of a substance by an alternative drug under consideration, for instance, of healthcare economics is possible only to a limited extent, since therapeutic effects as well as tolerability in the individual patient must be taken into account.