An update on the pharmacogenetic considerations when prescribing dopamine receptor agonists for Parkinson's disease

Expert Opin Drug Metab Toxicol. 2023 Jul-Dec;19(7):447-460. doi: 10.1080/17425255.2023.2249404. Epub 2023 Aug 24.


Introduction: Parkinson's disease is a chronic neurodegenerative multisystemic disorder that affects approximately 2% of the population over 65 years old. This disorder is characterized by motor symptoms which are frequently accompanied by non-motor symptoms such as cognitive disorders. Current drug therapies aim to reduce the symptoms and increase the patient's life expectancy. Nevertheless, there is heterogeneity in therapy response in terms of efficacy and adverse effects. This wide range in response may be linked to genetic variability. Thus, it has been suggested that pharmacogenomics may help to tailor and personalize drug therapy for Parkinson's disease.

Areas covered: This review describes and updates the clinical impact of genetic factors associated with the efficacy and adverse drug reactions related to common medications used to treat Parkinson's disease. Additionally, we highlight current informative recommendations for the drug treatment of Parkinson's disease.

Expert opinion: The pharmacokinetic, pharmacodynamic, and safety profiles of Parkinson's disease drugs do not favor the development of pharmacogenetic tests with a high probability of success. The chances of obtaining ground-breaking pharmacogenetics biomarkers for Parkinson's disease therapy are limited. Nevertheless, additional information on the metabolism of certain drugs, and an analysis of the potential of pharmacogenetics in novel drugs could be of interest.

Keywords: Adverse drug reactions; COMT inhibitors; Parkinson’s disease; dopamine receptor agonists; levodopa; monoamine oxidase inhibitors; pharmacogenetics.

Publication types

  • Review

MeSH terms

  • Aged
  • Antiparkinson Agents / adverse effects
  • Dopamine Agonists* / adverse effects
  • Dopamine Agonists* / pharmacokinetics
  • Humans
  • Levodopa / adverse effects
  • Parkinson Disease* / drug therapy
  • Parkinson Disease* / genetics
  • Pharmacogenetics


  • Dopamine Agonists
  • Antiparkinson Agents
  • Levodopa