Present and future drug treatment for Parkinson's disease.
Considerable advances made in defining the aetiology, pathogenesis, and pathology of Parkinson's disease (PD) have resulted in the development and rapid expansion of the pharmacopoeia available for treatment. Anticholinergics were used before the introduction of levodopa which is now the drug most commonly used. Dopamine agonists are effective when used alone or as an adjunct to levodopa, while monoamine oxidase B inhibitors improve motor function in early and advanced PD. However, treatment mainly addresses the dopaminergic features of the disease and leaves its progressive course unaffected; the drug treatment available for the management of non-motor symptoms is limited. This article seeks to set current treatment options in context, review emerging and novel drug treatments for PD, and assess the prospects for disease modification. Surgical therapies are not considered.
Schapira
A H V
AH
University Department of Clinical Neurosciences, Royal Free and University College Medical School, London NW3 2PF, UK. a.schapira@medsch.ucl.ac.uk
D052160:Benzothiazoles; D003342:Corpus Striatum / Q000187:drug effects / Q000473:pathology; D018450:Disease Progression; D018491:Dopamine Agonists / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D007189:Indans / Q000494:pharmacology / Q000627:therapeutic use*; D007211:Indoles / Q000494:pharmacology / Q000627:therapeutic use*; D007980:Levodopa / Q000627:therapeutic use; D008995:Monoamine Oxidase / Q000378:metabolism; D008996:Monoamine Oxidase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D000077487:Pramipexole; D011597:Psychomotor Performance / Q000187:drug effects; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology; D012893:Sleep Wake Disorders / Q000453:epidemiology; D013378:Substantia Nigra / Q000187:drug effects / Q000473:pathology; D013844:Thiazoles / Q000494:pharmacology / Q000627:therapeutic use*; D014549:Urinary Incontinence / Q000453:epidemiology
D052160:Benzothiazoles; D018491:Dopamine Agonists; D007189:Indans; D007211:Indoles; D008996:Monoamine Oxidase Inhibitors; D013844:Thiazoles; C031967:rasagiline; C046649:ropinirole; D007980:Levodopa; D000077487:Pramipexole; D008995:Monoamine Oxidase