Parkinsonism treatment: Part III--Update.
OBJECTIVE
The purpose of this review is to update clinicians with recent advances in the management of parkinsonism, including drug therapy, transplantation, and diet.


METHODS
Pertinent articles were obtained from an English-language literature search using MEDLINE (1970-1991), Index Medicus (1987-1991), Current Contents (1990), and bibliographic reviews of review articles. Index terms included parkinsonism, selegiline, pergolide, vitamin E, and transplantation. Fifty-five articles (representing 85 percent of the complete literature search) were selected by multiple reviewers for their contribution to the stated purpose. Emphasis was placed on double-blind, placebo-controlled, and randomized studies. Data from cited articles were examined by multiple reviewers for support of their stated hypothesis and were included as background for justification of major points in this article; critical studies were abstracted in more detail.


RESULTS
New therapeutic measures have been added to the treatment of parkinsonism. Selegiline, a monoamine oxidase inhibitor type B, has shown beneficial results, especially in early stages. Pergolide, a dopamine agonist, may be an efficacious alternative to bromocriptine resistance or intolerable adverse effects. Vitamin E may have protective antioxidant properties, but very few clinical data are available. Fetal tissue transplantation needs continued research and remains very controversial. Diet modification may maximize the results of therapy with exogenous dopamine therapy.


CONCLUSIONS
Clinicians should familiarize themselves with new alternatives for the management of parkinsonism in order to be reliable consultants for both professional and lay persons.
Collier
D S
DS
College of Pharmacy, University of Iowa, Iowa City 52242.
Berg
M J
MJ
Fincham
R W
RW
D000975:Antioxidants / Q000627:therapeutic use; D015259:Dopamine Agents / Q000627:therapeutic use; D005260:Female; D016332:Fetal Tissue Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010276:Parasympatholytics / Q000627:therapeutic use; D010300:Parkinson Disease / Q000628:therapy*; D010479:Pergolide / Q000627:therapeutic use; D012642:Selegiline / Q000627:therapeutic use; D014810:Vitamin E / Q000627:therapeutic use
D000975:Antioxidants; D015259:Dopamine Agents; D010276:Parasympatholytics; D014810:Vitamin E; D010479:Pergolide; D012642:Selegiline