[Pharmacological treatments of Parkinson's disease].
Antiparkinsonian agents applied or under the investigation for the treatment of patients with Parkinson's disease were reviewed. Tremor, akinesia, rigidity and postual instability are key signs of Parkinson's disease. The most important one is akinesia, which includes decreased spontaneous locomotor activity, slowness of movement, awkwardness and freezing. The main pathophysiology of Parkinson's disease is neurodegeneration of nigrostriatal dopaminergic neurons. Neurotoxins or oxidative stress to the dopaminergic neurons have been discussed as one of the etiologies of degeneration. Antioxidant or neuroprotective agents will be the future drugs for Parkinson's disease. At present, supplement of dopamine by levodopa administration, retarding the metabolism of levodopa or dopamine by a dopa decarboxylase inhibitor (DCI), MAO-B (monoamine oxidase inhibitor type B) inhibitor or catechol-O-methyltransferase (COMT) inhibitor, dopamine receptor agonists, anticholinergic agents, dopamine release enhancer/uptake inhibitor, N-methyl-D-aspartate (NMDA) receptor antagonists are applied for the treatment of Parkinson's disease. New agents such as adenosine receptor antagonists, serotonergic agents and nicotinic receptor agonists are under investigation. Agents to facilitate the growth of nerves or to inhibit degeneration of nerves are also studied and will be developed for the treatment of Parkinson's disease in the future. In the case of familial Parkinson's disease, abnormal genes were identified. Gene therapy might be another future treatment for these cases.
Department of Pharmacology, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. nomoto@m.kufm.kagoshima-u.ac.jp
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D000547:Amantadine; D000818:Animals; D000978:Antiparkinson Agents / Q000494:pharmacology / Q000627:therapeutic use; D065105:Aromatic Amino Acid Decarboxylase Inhibitors; D001577:Benzophenones; D002230:Carbidopa; D065098:Catechol O-Methyltransferase Inhibitors; D018491:Dopamine Agonists; D004791:Enzyme Inhibitors; D015316:Genetic Therapy; D006801:Humans; D007980:Levodopa; D008996:Monoamine Oxidase Inhibitors; D009596:Nitrophenols; D010300:Parkinson Disease / Q000209:etiology / Q000628:therapy; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors; D000077867:Tolcapone
D000978:Antiparkinson Agents; D065105:Aromatic Amino Acid Decarboxylase Inhibitors; D001577:Benzophenones; D065098:Catechol O-Methyltransferase Inhibitors; D018491:Dopamine Agonists; D004791:Enzyme Inhibitors; D008996:Monoamine Oxidase Inhibitors; D009596:Nitrophenols; D016194:Receptors, N-Methyl-D-Aspartate; D007980:Levodopa; D000547:Amantadine; D000077867:Tolcapone; D002230:Carbidopa