Pharmacotherapy of Parkinson's disease: research from 1960 to 1991.
The last decades have been characterized by impressive research activity in connection with Parkinson's disease (PD). A wealth of new results have enriched our knowledge of the pathophysiology of the disorder and led to new approaches for its therapy. Whereas anticholinergic drugs remained the main, though unsatisfactory, treatment of PD for almost 100 years, the situation has changed since the 1960s. An impetus for this turning-point was given by the finding that the striatum of rats contained a high concentration of dopamine (DA) which until then had been considered to be a mere intermediate of the biosynthesis of noradrenaline and adrenaline, without a physiological role in its own right. Subsequently, the role of dopamine as neurotransmitter and the importance of dopaminergic pathways for the control of extrapyramidal motricity were firmly established. As a consequence, new therapeutic possibilities emerged and the anticholinergic drugs, although still in use, lost their supremacy. The present minireview will be restricted to new treatments which have been developed and introduced since 1960 and to recent pharmacotherapeutic approaches with potential future usefulness.
Pletscher
A
A
Swiss Academy of Medical Sciences, Basel.
DaPrada
M
M
D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002262:Carboxy-Lyases / Q000037:antagonists & inhibitors / Q000502:physiology; D002394:Catechol O-Methyltransferase / Q000502:physiology; D065098:Catechol O-Methyltransferase Inhibitors; D003342:Corpus Striatum / Q000187:drug effects / Q000503:physiopathology; D004298:Dopamine / Q000502:physiology; D015259:Dopamine Agents / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use; D008996:Monoamine Oxidase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology; D013378:Substantia Nigra / Q000187:drug effects / Q000503:physiopathology
D000978:Antiparkinson Agents; D065098:Catechol O-Methyltransferase Inhibitors; D015259:Dopamine Agents; D008996:Monoamine Oxidase Inhibitors; D007980:Levodopa; D002394:Catechol O-Methyltransferase; D002262:Carboxy-Lyases; D004298:Dopamine