Safety overview of FDA-approved medications for the treatment of the motor symptoms of Parkinson's disease

Expert Opin Drug Saf. 2014 Aug;13(8):1055-69. doi: 10.1517/14740338.2014.931369. Epub 2014 Jun 24.

Abstract

Introduction: Parkinson's disease (PD) is among the most common of the neurodegenerative disorders. Treatment is primarily focused on correcting neurotransmitter imbalances. Several classes of medication are available for this purpose.

Areas covered: A Medline search was performed to gather information about the safety of the medications approved for the treatment of the motor symptoms of PD. This was supplemented with additional articles obtained from online sources and information provided by the FDA and the manufacturers. The focus of this review is the side-effect and safety profiles of carbidopa/levodopa, dopamine agonists, selective monoamine oxidase inhibitors, catechol-o-methyltransferase inhibitors, anticholinergics and amantadine.

Expert opinion: Though serious side-effects may occur, as a group, the medications used for the treatment of PD motor symptoms tend to produce side-effects that are mild to moderate in nature, and that primarily reflect the focus on dopaminergic therapies. Care plans for Parkinson's patients should be approached based on the needs of the individual as disease presentation, lifestyle, level of disability, concurrent disease states and the presence of non-motor symptoms make each case unique. Patients and caregivers must have realistic expectations about the use of PD medications.

Keywords: Parkinson’s disease; amantadine; anticholinergics; catechol-O-methyltransferase; catechol-O-methyltransferase inhibitors; dopamine agonists; dyskinesia; levodopa; monoamine oxidase; monoamine oxidase inhibitors.

Publication types

  • Review

MeSH terms

  • Antiparkinson Agents / adverse effects*
  • Antiparkinson Agents / therapeutic use
  • Dopamine / metabolism
  • Dopamine Agents / adverse effects*
  • Dopamine Agents / therapeutic use
  • Drug Approval
  • Humans
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / physiopathology
  • United States
  • United States Food and Drug Administration

Substances

  • Antiparkinson Agents
  • Dopamine Agents
  • Dopamine