Are All Dopamine Agonists Essentially the Same?

Dopamine agonists (DAs) represent an excellent treatment option for patients with Parkinson's disease, in both the early and advanced stages of the disease, improving motor symptoms, lowering the incidence of motor complications, and addressing several non-motor symptoms. Indeed, each of these compounds have different pharmacokinetic and pharmacodynamic properties, resulting in a unique efficacy and safety profile. Comorbidities, prominent non-motor symptoms and individual subjects' clinical characteristics should guide the choice of a specific DA, allowing better management of the patient by optimizing the DA benefit/risk ratio. In this article we discuss brain distribution of dopamine receptors and their role in each of the dopaminergic pathways, the pharmacological profile of non-ergoline DAs and class-related adverse effects, as reported from post-marketing studies.