Limitations of current Parkinson's disease therapy

Ann Neurol. 2003:53 Suppl 3:S3-12; discussion S12-5. doi: 10.1002/ana.10513.

Abstract

Levodopa and other dopaminergic medications drastically improve the motor symptoms and quality of life of patients with Parkinson's disease in the early stages of the disease. However, once the "honeymoon" period has waned, usually after a few years of dopaminergic therapy, patients become progressively more disabled despite an ever more complex combination of available antiparkinsonian treatments. Sooner or later, they suffer from "dopa-resistant" motor symptoms (speech impairment, abnormal posture, gait and balance problems), "dopa-resistant" nonmotor signs (autonomic dysfunction, mood and cognitive impairment, sleep problems, pain) and/or drug-related side effects (especially psychosis, motor fluctuations, and dyskinesias). Therefore, the current antiparkinsonian therapy cannot be considered as ideal with regard to both efficacy and safety.

Publication types

  • Review

MeSH terms

  • Antiparkinson Agents / adverse effects
  • Antiparkinson Agents / classification
  • Antiparkinson Agents / therapeutic use*
  • Cognition Disorders / chemically induced
  • Drug Resistance
  • Dysarthria / chemically induced
  • Dyskinesia, Drug-Induced / etiology
  • Electric Stimulation Therapy / methods
  • Globus Pallidus / physiology
  • Globus Pallidus / surgery
  • Humans
  • Neurosurgical Procedures
  • Parkinson Disease / drug therapy
  • Parkinson Disease / surgery
  • Parkinson Disease / therapy*
  • Psychoses, Substance-Induced / etiology
  • Quality of Life
  • Subthalamic Nucleus / physiology
  • Subthalamic Nucleus / surgery

Substances

  • Antiparkinson Agents