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Treatment of Parkinson's disease.
J Clin Neurosci. 2000 Nov; 7(6):484-94.JC

Abstract

The aim of current treatment of Parkinson's disease is to ameliorate the symptoms while seeking to lessen the potential development of late levodopa complications. To this end, there is ample evidence that the early use of dopamine agonists is beneficial in younger Parkinsonian patients but monotherapy with dopamine agonists is for only a select few. Nonergot dopamine agonists offer the potential for fewer side effects. Lower dose levodopa therapy delays the onset and reduces severity of dyskinesia and end of dose failure. However levodopa remains the treatment of choice in Parkinson's disease and should not be restricted unnecessarily in patients with disability. There is no evidence that levodopa is toxic to dopaminergic neurons in people with Parkinson's disease. As yet, no drugs are of proven neuroprotective value. Dopamine agonists, catechol-o-methyltransferase inhibitors, amantadine and apomorphine have differing but beneficial roles in the management of levodopa side effects. Ablative surgery and deep brain stimulation of thalamus, globus pallidus and subthalamic nucleus are increasingly available but choice of procedure depends not just on patient symptomatology, but also on local experience and results. Ideally, deep brain stimulation is the treatment of choice as it offers less morbidity than bilateral ablative surgery, the possibility of postoperative adjustments and the potential for reversibility if better treatments become available.

Authors+Show Affiliations

Department of Neurology, Westmead Hospital, Westmead, NSW, 2145, Australia.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

11029227

Citation

Hely, M A., et al. "Treatment of Parkinson's Disease." Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, vol. 7, no. 6, 2000, pp. 484-94.
Hely MA, Fung VS, Morris JG. Treatment of Parkinson's disease. J Clin Neurosci. 2000;7(6):484-94.
Hely, M. A., Fung, V. S., & Morris, J. G. (2000). Treatment of Parkinson's disease. Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, 7(6), 484-94.
Hely MA, Fung VS, Morris JG. Treatment of Parkinson's Disease. J Clin Neurosci. 2000;7(6):484-94. PubMed PMID: 11029227.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of Parkinson's disease. AU - Hely,M A, AU - Fung,V S, AU - Morris,J G, PY - 2000/10/13/pubmed PY - 2001/6/2/medline PY - 2000/10/13/entrez SP - 484 EP - 94 JF - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia JO - J Clin Neurosci VL - 7 IS - 6 N2 - The aim of current treatment of Parkinson's disease is to ameliorate the symptoms while seeking to lessen the potential development of late levodopa complications. To this end, there is ample evidence that the early use of dopamine agonists is beneficial in younger Parkinsonian patients but monotherapy with dopamine agonists is for only a select few. Nonergot dopamine agonists offer the potential for fewer side effects. Lower dose levodopa therapy delays the onset and reduces severity of dyskinesia and end of dose failure. However levodopa remains the treatment of choice in Parkinson's disease and should not be restricted unnecessarily in patients with disability. There is no evidence that levodopa is toxic to dopaminergic neurons in people with Parkinson's disease. As yet, no drugs are of proven neuroprotective value. Dopamine agonists, catechol-o-methyltransferase inhibitors, amantadine and apomorphine have differing but beneficial roles in the management of levodopa side effects. Ablative surgery and deep brain stimulation of thalamus, globus pallidus and subthalamic nucleus are increasingly available but choice of procedure depends not just on patient symptomatology, but also on local experience and results. Ideally, deep brain stimulation is the treatment of choice as it offers less morbidity than bilateral ablative surgery, the possibility of postoperative adjustments and the potential for reversibility if better treatments become available. SN - 0967-5868 UR - https://www.unboundmedicine.com/medline/citation/11029227/Treatment_of_Parkinson's_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0967-5868(00)90766-5 DB - PRIME DP - Unbound Medicine ER -