Treatment options for non-motor symptoms in late-stage Parkinson's disease.
Late-stage Parkinson's disease is characterised by patients dependent on caregivers for their activities of daily living, even under the best levodopa benefit. Non-motor signs that overcome the well-known motor signs of Parkinson's disease dominate late-stage Parkinson's disease and few systematic data exist for the treatment of these signs. The objective of this study was to review the treatment options for Parkinson's disease dementia, psychosis, falls, bone fractures, joint and skeletal deformities, pain, orthostatic hypotension, gastrointestinal abnormalities and urological dysfunction in late-stage Parkinson's disease. The study analysed the available controlled clinical trials for the above medical conditions. When absent, data from case series and the authors' own experience was considered. Few controlled clinical trials specifically addressed late-stage Parkinson's disease as a target population. There is a need for therapeutic data on the symptoms that most afflict late-stage Parkinson's disease patients.
Coelho
Miguel
M
Neurological Clinical Research Unit, Institute of Molecular Medicine, Av. Professor Egas Moniz, 1649-028, Lisbon, Portugal. migcoelho2002@yahoo.es
Ferreira
Joaquim
J
Rosa
Mário
M
Sampaio
Cristina
C
D000058:Accidental Falls / Q000517:prevention & control; D000203:Activities of Daily Living; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001847:Bone Diseases / Q000188:drug therapy / Q000209:etiology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003704:Dementia / Q000188:drug therapy / Q000209:etiology; D018450:Disease Progression; D019317:Evidence-Based Medicine; D050723:Fractures, Bone / Q000188:drug therapy / Q000209:etiology; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D005767:Gastrointestinal Diseases / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007024:Hypotension, Orthostatic / Q000188:drug therapy / Q000209:etiology; D007592:Joint Diseases / Q000209:etiology / Q000628:therapy; D009788:Occupational Therapy; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D026741:Physical Therapy Modalities; D011788:Quality of Life; D016896:Treatment Outcome; D014555:Urination Disorders / Q000188:drug therapy / Q000209:etiology; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
D014150:Antipsychotic Agents; D050071:Bone Density Conservation Agents; D002800:Cholinesterase Inhibitors; D005765:Gastrointestinal Agents; D014662:Vasoconstrictor Agents