Initial agonist treatment of Parkinson disease: a critique.
The evidence supporting initial dopamine agonist treatment of PD is reviewed. The two rationales for initial agonist treatment are reduced frequency of motor complications and possible relative neuroprotection by dopamine agonists. The basic science supporting these rationales is equivocal. The clinical evidence for advantages of initial agonist treatment is incomplete. More data are required to determine the optimal initial treatment for PD.
Albin
Roger L
RL
Department of Neurology, Geriatric Research, Education, and Clinical Center, Ann Arbor VAMC, University of Michigan, Ann Arbor, USA. ralbin@umich.edu
Frey
Kirk A
KA
D000818:Animals; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001667:Binding, Competitive / Q000187:drug effects; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D015986:Confounding Factors, Epidemiologic; D018491:Dopamine Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D050483:Dopamine Plasma Membrane Transport Proteins; D004409:Dyskinesia, Drug-Induced / Q000209:etiology; D006801:Humans; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use; D008562:Membrane Glycoproteins; D026901:Membrane Transport Proteins / Q000378:metabolism; D009043:Motor Activity / Q000187:drug effects; D009419:Nerve Tissue Proteins; D018696:Neuroprotective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000188:drug therapy* / Q000378:metabolism; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D018491:Dopamine Agonists; D050483:Dopamine Plasma Membrane Transport Proteins; D008562:Membrane Glycoproteins; D026901:Membrane Transport Proteins; D009419:Nerve Tissue Proteins; D018696:Neuroprotective Agents; D007980:Levodopa