The concept of continuous dopaminergic stimulation: what we should consider when starting Parkinson's disease treatment.
Treatment of early Parkinson's disease (PD) should pursue objectives like possible disease-modifying effect, more physiological dopaminergic stimulation, and avoidance of motor fluctuations. The recent published ADAGIO trial showed that rasagiline (1 mg/day), used in early PD, has a disease-modifying effect. Dopaminergic drugs administered to provide more continuous dopaminergic stimulation prevent or minimize motor fluctuations in experimental animals. Dopamine (DA) agonists delay motor fluctuations in humans providing a more continuous dopaminergic stimulation. New formulations of DA agonists, such as once a day preparations and patch technology, have been developed to provide a more continuous delivery of drug and consequently a more physiological stimulation. According to patient characteristics, treatment of PD should be started with rasagiline and/or with long-acting DA agonists.
Stocchi
Fabrizio
F
Department of Neurology, Institute of Research and Medical Care IRCCS San Raffaele, Rome, Italy. fabrizio.stocchi@sanraffaele.it
D004298:Dopamine / Q000378:metabolism*; D018491:Dopamine Agonists / Q000627:therapeutic use*; D006801:Humans; D010300:Parkinson Disease / Q000378:metabolism / Q000628:therapy*; D013764:Tetrahydronaphthalenes / Q000627:therapeutic use*; D013876:Thiophenes / Q000627:therapeutic use*
D018491:Dopamine Agonists; D013764:Tetrahydronaphthalenes; D013876:Thiophenes; C047508:rotigotine; D004298:Dopamine