Medication Management of Parkinson's Disease: Early versus Advanced Stages

Shin Chia Tsai, Rey Yue Yuan

研究成果: 雜誌貢獻文章

3 引文 (Scopus)

摘要

Parkinson's disease (PD) is a progressive neurodegenerative disease that mainly affects extrapyramidal motor function. Dopamine replacement therapy by levodopa (L-DOPA) is the best treatment for motor control. Moreover, dopamine agonists (DAs), monoamine oxidase type B (MAO-B) inhibitors, anticholinergic agents, catechol O-methyl transferase (COMT) inhibitors and amantadine are used mostly as adjuvant therapeutics. MAO-B inhibitors, especially selegiline may have potential neuroprotective effects, and anticholinergic agents play a role in tremor alleviation. Non-ergot DAs (e.g., pramipexole or ropinirole) substitute for the ergot ones (e.g., pergolide) due to having less cardiac valve problems. Initiation of either DAs or L-DOPA can be used for managing bradykinesia and rigidity in young and elderly patients, respectively. Chronic use of L-DOPA may induce motor complications, including motor fluctuations and dyskinesias in advanced PD. For reducing off time, inhibitors of COMT and/or MAO-B could be added. For reducing dyskinesias, amantadine may be considered. Pramipexole and ropinirole have been used recently as the initial treatment for young PD patients. Nonmotor symptoms (e.g., depression) are also important comorbidities in PD patients. Pramipexole and selegiline may be used in treating motor and depressive problems simultaneously in addition to their antiparkinsonian effects. All current antiparkinsonian medications alleviate merely extrapyramidal symptoms. Drugs for PD in the future should be targeting the disease progression.

原文英語
頁(從 - 到)209-214
頁數6
期刊Journal of Experimental and Clinical Medicine(Taiwan)
4
發行號4
DOIs
出版狀態已發佈 - 八月 2012

指紋

Parkinson Disease
Dopamine Agonists
Levodopa
Guaiacol
Antiparkinson Agents
Selegiline
Amantadine
Monoamine Oxidase Inhibitors
Dyskinesias
Cholinergic Antagonists
Neuroprotective Agents
Transferases
Pergolide
Hypokinesia
Heart Valves
Monoamine Oxidase
Tremor
Therapeutics
Neurodegenerative Diseases
Disease Progression

ASJC Scopus subject areas

  • Medicine(all)

引用此文

Medication Management of Parkinson's Disease : Early versus Advanced Stages. / Tsai, Shin Chia; Yuan, Rey Yue.

於: Journal of Experimental and Clinical Medicine(Taiwan), 卷 4, 編號 4, 08.2012, p. 209-214.

研究成果: 雜誌貢獻文章

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