Advances in the management of parkinson's disease

The treatment of Parkinson's disease today is complex, time-consuming, but rewarding. The introduction of levodopa has not cured the disease, but has provided the most powerful therapy available yet. Its use is limited by side effects and careful titration to optimum dosage, often in combination with other drugs, is required. Despite best therapy, some patients never respond, and others begin to lose benefit after some years of therapy. New problems, such as the "on-off" effect have appeared with long-term treatment, and require careful adjustment of dosage. As with any replacement therapy, a balance between sub-optimal benefit and side effects has to be discovered and maintained by careful and frequent review. New approaches to treatment may offer further improvement in the near future.