[Guidelines of drug therapies for Parkinson's disease]

Treatment of Parkinson's disease has progressed steadily for the last decades after introduction of levodopa. For recovery of striatal dysfunction caused by loss of projecting nigral cells, supplementation of neurotransmitter dopamine (DA), facilitation of neural transmission by DA agonists and amantadine, suppression of acetyl-choline neurons, having antagonistic action to DA cells, are all effective especially at the early to middle stages of illness. As prevention of neuronal cell death in parkinsonian brain has not yet been succeeded, difficulties in treatment with symptom fluctuation and CNS side effects such as dyskinesia or psychic symptoms develop inevitably in the long course of evodopa treatment. Proper choice of drugs for parkinsonian core and accompanying symptoms and selection of methods of medication for maintenance of natural daily life activities are necessary for attainment of good QOL for whole time course of the disease.