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Current approaches to the treatment of Parkinson's disease.

Jankovic J, Aguilar LG - Neuropsychiatr Dis Treat (2008)

Bottom Line: As a result of advances in experimental therapeutics, many promising therapies for PD are emerging.Levodopa remains the most potent drug for controlling PD symptoms, yet is associated with significant complications such as the "wearing off" effect, levodopa-induced dyskinesias and other motor complications.Catechol-o-methyl-transferase inhibitors, dopamine agonists and nondopaminergic therapy are alternative modalities in the management of PD and may be used concomitantly with levodopa or one another.

View Article: PubMed Central - PubMed

Affiliation: Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, 6550 Fannin, Suite 1801, Houston, Texas 77030, USA.

ABSTRACT
Enormous progress has been made in the treatment of Parkinson's disease (PD). As a result of advances in experimental therapeutics, many promising therapies for PD are emerging. Levodopa remains the most potent drug for controlling PD symptoms, yet is associated with significant complications such as the "wearing off" effect, levodopa-induced dyskinesias and other motor complications. Catechol-o-methyl-transferase inhibitors, dopamine agonists and nondopaminergic therapy are alternative modalities in the management of PD and may be used concomitantly with levodopa or one another. The neurosurgical treatment, focusing on deep brain stimulation, is reviewed briefly. Although this review has attempted to highlight the most recent advances in the treatment of PD, it is important to note that new treatments are not necessarily better than the established conventional therapy and that the treatment options must be individualized and tailored to the needs of each individual patient.

No MeSH data available.


Related in: MedlinePlus

Treatment guidelines for the progressive stages of Parkinson’s disease.Abbreviations: COMT, catechol-o-methyl-transferase; DBS, deep brain stimulation; MAO, monoamine oxidase.
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fig2: Treatment guidelines for the progressive stages of Parkinson’s disease.Abbreviations: COMT, catechol-o-methyl-transferase; DBS, deep brain stimulation; MAO, monoamine oxidase.

Mentions: The most important principle in the management of PD is to individualize therapy and to target the most disabling symptoms. The selected therapy should be based on scientific rationale and designed not only to control symptoms, but also to slow the progression of the disease (Figure 2). Since younger patients are likely to require dopaminergic therapy for longer time and are at increased risk for the development of levodopa complications, levodopa sparing strategies, such as the use of MAO inhibitors and DA agonists, are even more critical in this population (Jankovic 2000). Certain symptoms of PD, such as dysarthria, dysphagia, freezing and other “axial” symptoms, usually do not respond to dopaminergic therapy and may be mediated by nondopaminergic systems (Bonnet 2000; Kompoliti et al 2000). It is very likely that with better understanding of the mechanisms of neurodegeneration, novel and more effective therapeutic strategies will be available in the near future.


Current approaches to the treatment of Parkinson's disease.

Jankovic J, Aguilar LG - Neuropsychiatr Dis Treat (2008)

Treatment guidelines for the progressive stages of Parkinson’s disease.Abbreviations: COMT, catechol-o-methyl-transferase; DBS, deep brain stimulation; MAO, monoamine oxidase.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2536542&req=5

fig2: Treatment guidelines for the progressive stages of Parkinson’s disease.Abbreviations: COMT, catechol-o-methyl-transferase; DBS, deep brain stimulation; MAO, monoamine oxidase.
Mentions: The most important principle in the management of PD is to individualize therapy and to target the most disabling symptoms. The selected therapy should be based on scientific rationale and designed not only to control symptoms, but also to slow the progression of the disease (Figure 2). Since younger patients are likely to require dopaminergic therapy for longer time and are at increased risk for the development of levodopa complications, levodopa sparing strategies, such as the use of MAO inhibitors and DA agonists, are even more critical in this population (Jankovic 2000). Certain symptoms of PD, such as dysarthria, dysphagia, freezing and other “axial” symptoms, usually do not respond to dopaminergic therapy and may be mediated by nondopaminergic systems (Bonnet 2000; Kompoliti et al 2000). It is very likely that with better understanding of the mechanisms of neurodegeneration, novel and more effective therapeutic strategies will be available in the near future.

Bottom Line: As a result of advances in experimental therapeutics, many promising therapies for PD are emerging.Levodopa remains the most potent drug for controlling PD symptoms, yet is associated with significant complications such as the "wearing off" effect, levodopa-induced dyskinesias and other motor complications.Catechol-o-methyl-transferase inhibitors, dopamine agonists and nondopaminergic therapy are alternative modalities in the management of PD and may be used concomitantly with levodopa or one another.

View Article: PubMed Central - PubMed

Affiliation: Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, 6550 Fannin, Suite 1801, Houston, Texas 77030, USA.

ABSTRACT
Enormous progress has been made in the treatment of Parkinson's disease (PD). As a result of advances in experimental therapeutics, many promising therapies for PD are emerging. Levodopa remains the most potent drug for controlling PD symptoms, yet is associated with significant complications such as the "wearing off" effect, levodopa-induced dyskinesias and other motor complications. Catechol-o-methyl-transferase inhibitors, dopamine agonists and nondopaminergic therapy are alternative modalities in the management of PD and may be used concomitantly with levodopa or one another. The neurosurgical treatment, focusing on deep brain stimulation, is reviewed briefly. Although this review has attempted to highlight the most recent advances in the treatment of PD, it is important to note that new treatments are not necessarily better than the established conventional therapy and that the treatment options must be individualized and tailored to the needs of each individual patient.

No MeSH data available.


Related in: MedlinePlus