[The therapy of wearing-off].
Wearing-off, predictable end of dose deterioration, is one of the major problems of long-term levodopa treatment for Parkinson's disease. The mechanisms of wearing-off are (1) loss of striatal dopamine storage, (2) change in the peripheral pharmacokinetics of levodopa and (3) modification of dopamine receptors. The main therapeutic strategy for wearing-off is continuous stimulation of dopamine system. For this purpose, we increase frequency of levodopa doses and use long half-life dopamine agonist(continuous stimulation of dopamine receptors), COMT inhibitor and MAOB inhibitor (prolongation of the half-life of levodopa and dopamine), and zonisamide (long-term increase of dopamine synthesis).
Department of Neurology, Musashi Hospital, National Center of Neurology and Psychiatry.
Miho
M
Murata
D000367:Age Factors; D018491:Dopamine Agonists / Q000008:administration & dosage; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage*; D010300:Parkinson Disease / Q000188:drug therapy*
D018491:Dopamine Agonists; D007980:Levodopa