The next chapter in symptomatic Parkinson disease treatments

Significant advances in the symptomatic treatment of Parkinson disease (PD) have occurred since the discovery of levodopa (LD). Perhaps as a testament to its unparalleled efficacy, novel formulations aiming to optimize LD delivery to obtain better bioavailability, longer duration of effect and less plasma level fluctuations remain a major focus of drug development, nearly 5 decades since it was first commercially used. In addition, alternative apomorphine delivery formulations are also in development to provide rapid-acting, needle-free agents for the management of "off" episodes in patients experiencing motor fluctuations. "Non-dopaminergic" approaches have also emerged as promising treatments targeting different pathways to enhance the modulation of dopaminergic and neuroprotective mechanisms. This paper focuses on reviewing the evidence on the latest advances in non-surgical, symptomatic motor PD treatment.