Pharmacologic treatment of Parkinson disease – UpToDate

INTRODUCTION

The array of pharmacologic and surgical treatments available for the treatment of idiopathic (or Lewy body) Parkinson disease (PD) is broader than for any other degenerative disease of the central nervous system. Management of individual patients requires careful consideration of a number of factors, including the patient's symptoms and signs, age, stage of disease, degree of functional disability, and level of physical activity and productivity. Treatment can be divided into pharmacologic, nonpharmacologic, and surgical therapy.

The pharmacologic treatment of PD can be further divided into neuroprotective and symptomatic therapy. In practice, nearly all of the available treatments are symptomatic in nature and do not appear to slow or reverse the natural course of the disease. However, several potential neuroprotective agents for PD have shown some promise in animals and/or humans and are undergoing further investigation. Neuroprotective therapy for PD is discussed in greater detail separately. (See "Neuroprotective therapy for Parkinson disease".)

The routine medical management of PD is reviewed here. The nonpharmacologic management of PD, including education, support, exercise, and nutrition, is discussed separately. (See "Nonpharmacologic management of Parkinson disease".)

Treatment of advanced PD, particularly the complications associated with long-term levodopa therapy, and management of the comorbid problems including daytime sleepiness, hallucinations, and psychosis, are reviewed elsewhere. (See "Motor fluctuations and dyskinesia in Parkinson disease" and "Surgical treatment of Parkinson disease" and "Management of nonmotor symptoms in Parkinson disease".)

Correct diagnosis is fundamental to the appropriate therapy of PD, although the same menu of antiparkinson drugs is used to treat all of the various parkinsonian syndromes. The diagnosis of PD is reviewed in detail separately. (See "Diagnosis and differential diagnosis of Parkinson disease".)

Literature review current through: Feb 2017. | This topic last updated: Tue Sep 13 00:00:00 GMT+00:00 2016.

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Pharmacologic treatment of Parkinson disease - UpToDate