Semin Neurol 2007; 27: 97-105 DOI: 10.1055/s-2007-971177
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.
Drug Therapy for Parkinson's Disease
Neal Hermanowicz1
1 Department of Neurology, Movement Disorders Program, University of California-Irvine; Phillip and Carol Traub Center for Parkinson's Disease, Eisenhower Medical Center, Rancho Mirage, California

ABSTRACT

The fundamental concepts of the medical treatment of Parkinson's disease are simple, and remain based on the enhancement of dopaminergic transmission by means of levodopa and dopamine agonists. Recently published practice parameters from the American Academy of Neurology and an evidence-based review under the auspices of the Movement Disorder Society provide guidance on motor complications and also cognitive and psychiatric issues associated with Parkinson's disease. The choices of medications are increasing as are the routes of administration, with the arrival of injectable and transdermal dopamine agonists and a monoamine inhibitor absorbed via the buccal mucosa. Although simple conceptually, the actual care of patients with Parkinson's disease is often complex, requiring consideration of potential future complications and individualized medication regimens, and minimizing the adverse effects of medications that range from unpleasant to seriously disturbing.

KEYWORDS

Parkinson's disease - levodopa - dopamine agonists - COMT inhibition - MAO inhibition - dyskinesias - impulse control disorder