title: Dopamine receptor agonists for Parkinson's disease.
abstract: BACKGROUND
  Prolonged administration of l-3,4-dihydroxyphenylalanine (l-DOPA) for Parkinson's disease (PD) is hampered by motor complications related to the progressive incapacity of residual nigrostriatal neurons to properly utilize the drug. Direct stimulation of dopaminergic (DAergic) receptors with specific compounds (DA agonists) has, therefore, become an additional therapeutic tool for PD.
  
  
  METHODS
  DA agonists have considerable anti-parkinsonian symptomatic efficacy, although they are less potent than l-DOPA. This review summarizes pre-clinical and clinical data on DA agonists and their role in treating PD. Specific focus was put on second-generation, first-line non-ergolinic DA agonists and their motor, non-motor and putative neuroprotective effects. The anti-parkinsonian potential of recently developed DA agonists that reached Phase II and III clinical trials was also addressed.
  
  
  CONCLUSIONS
  DA agonists can be useful along the whole natural course of PD, as monotherapy in the initial phase or combined with l-DOPA in advanced PD. Extended-release formulations have been developed for second-generation DA agonists, which are better appreciated by patients. Neuroprotective properties have been proposed for DA agonists, based on pre-clinical studies, but never convincingly demonstrated in patients. New DA agonists, with better symptomatic efficacy and devoid of the side effects that characterize current compounds, are needed.
authors: IRCCS National Neurological Institute C. Mondino, Center for Research in Neurodegenerative Diseases , Via Mondino 2, 27100 Pavia , Italy +39 0382 380416 ; +39 0382 380448 ; fabio.blandini@mondino.it.
authors: Fabio
authors: F
authors: Blandini
authors: Marie-Therese
authors: MT
authors: Armentero
mesh_terms: D000818:Animals; D018491:Dopamine Agonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D018696:Neuroprotective Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000188:drug therapy*
chemical_list: D018491:Dopamine Agonists; D018696:Neuroprotective Agents