[Toxic drug effects of antiparkinson therapy and their preventability]

Parkinson's disease is an illness occurring in the third stage of life. At times, the patient suffers from arteriosclerosis as well. Reconstruction processes caused by aging are under way in the brain, which affect, among others, the synapses and transmitter substances. The biotransformation of medication may be changed in elderly persons. The tendency to multimorbidity leads to consumption of several drugs at the same time, possibly causing interference symptoms. Changes in transmitter balance and receptor excitability are, however, the main causes of the toxic side-effects of anti Parkinson therapy. The greater the nigrostriatal degeneration, the lower the tolerance level. Recently, in addition to basic therapy consisting of reduced doses of combined dopa preparations and/or Amantadine sulphate, dopaminergic agonists are used, which act on the receptors which have been maintained. This prevents some side-effects and stabilizes the patient's unpleasant daily fluctuations. Reducing the dosage prevents dyskinesia. pharmacotoxic psychoses require neuroleptics of the Thiaxanthen group or change-over to i.v. Amantadine sulphate infusions or Lisuride i.v.