[Comment on guidelines for treatment of Parkinson's disease].
The guidelines for the therapy of Parkinson's disease (PD) based on the concept of evidence-based medicine (EBM) were edited by the Japanese Society of Neurology in 2002. The author described his impression of these guidelines from a user's viewpoint after using these guidelines. In the chapter on the therapeutic efficacy and safety of drugs, compared with other antiparkinsonian drugs, levodopa seems to be only briefly described. Because the therapy of PD highly depends on the effect of levodopa, a more detailed description of levodopa will be helpful for neurologists. In the chapter on general and detailed discussions, the use of a dopamine agonist (DA) for young PD patients is recommended because DA prevents motor complications; this is the most emphasized part based on the concept of EBM in the guidelines. Measures of managing various complications based on various lines of evidence and experiences of members of Ad hoc committee for the treatment of PD are well documented in this chapter. In general, since the guidelines are technical ones, they clearly describe how to treat PD patients. For the effective use of these guidelines, neurologists should have the ability to correctly determine PD symptoms, some knowledge about the pharmacology of antiparkinsonian drugs particularly levodopa and DA, and balanced thinking regarding the management of PD patients.
Kondo
Tomoyoshi
T
Department of Neurology, Wakayama Medical University.
D019317:Evidence-Based Medicine; D006801:Humans; D010300:Parkinson Disease / Q000188:drug therapy*; D017410:Practice Guidelines as Topic