Treatment of levodopa‐induced motor complications
Identifieur interne : 000723 ( Main/Corpus ); précédent : 000722; suivant : 000724Treatment of levodopa‐induced motor complications
Auteurs : Fabrizio Stocchi ; Michele Tagliati ; C. Warren OlanowSource :
- Movement Disorders [ 0885-3185 ] ; 2008.
English descriptors
Abstract
Chronic levodopa treatment for Parkinson's disease patients is frequently associated with the development of motor complications such as end‐of‐dose wearing‐off and dyskinesias. In this review, we provide an overview of the strategies available for dealing with these problems. Medical management includes manipulation of levodopa dosing to establish the optimum treatment schedule, improving levodopa absorption, catechol‐O‐methyl transferase‐inhibition (COMT), Monoamine oxidase‐B (MAO‐B) inhibition, dopaminergic agonists, amantadine, and continuous dopaminergic infusions. Surgical procedures and particularly deep brain stimulation are also reviewed. It should be noted that none of these treatments has been shown to provide anti‐parkinsonian efficacy that is greater than what can be achieved with levodopa. We highlight the importance of initiating therapy with a treatment strategy that reduces the risk that a Parkinson's disease patient will develop motor complications in the first place. Key Words: Advanced PD, dyskinesias, motor fluctuations, levodopa, dopamine agonists, COMT inhibitors, MAO‐B inhibitors. © 2008 Movement Disorder Society
Url:
DOI: 10.1002/mds.22052
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ISTEX:FB819C4FEC283B3BB9A75DE1B178F8C4EF044955Le document en format XML
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In this review, we provide an overview of the strategies available for dealing with these problems. Medical management includes manipulation of levodopa dosing to establish the optimum treatment schedule, improving levodopa absorption, catechol‐<i>O</i>‐methyl transferase‐inhibition (COMT), Monoamine oxidase‐B (MAO‐B) inhibition, dopaminergic agonists, amantadine, and continuous dopaminergic infusions. Surgical procedures and particularly deep brain stimulation are also reviewed. It should be noted that none of these treatments has been shown to provide anti‐parkinsonian efficacy that is greater than what can be achieved with levodopa. We highlight the importance of initiating therapy with a treatment strategy that reduces the risk that a Parkinson's disease patient will develop motor complications in the first place. 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Warren</namePart><namePart type="family">Olanow</namePart><affiliation>Mount Sinai School of Medicine, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2008</dateIssued><dateCaptured encoding="w3cdtf">2007-12-31</dateCaptured><dateValid encoding="w3cdtf">2008-03-02</dateValid><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="references">153</extent><extent unit="words">10023</extent></physicalDescription><abstract lang="en">Chronic levodopa treatment for Parkinson's disease patients is frequently associated with the development of motor complications such as end‐of‐dose wearing‐off and dyskinesias. In this review, we provide an overview of the strategies available for dealing with these problems. Medical management includes manipulation of levodopa dosing to establish the optimum treatment schedule, improving levodopa absorption, catechol‐O‐methyl transferase‐inhibition (COMT), Monoamine oxidase‐B (MAO‐B) inhibition, dopaminergic agonists, amantadine, and continuous dopaminergic infusions. Surgical procedures and particularly deep brain stimulation are also reviewed. It should be noted that none of these treatments has been shown to provide anti‐parkinsonian efficacy that is greater than what can be achieved with levodopa. We highlight the importance of initiating therapy with a treatment strategy that reduces the risk that a Parkinson's disease patient will develop motor complications in the first place. Key Words: Advanced PD, dyskinesias, motor fluctuations, levodopa, dopamine agonists, COMT inhibitors, MAO‐B inhibitors. © 2008 Movement Disorder Society</abstract><note type="content">*Potential conflict of interest: Dr. Stocchi has received honoraria for consultation from Novartis, GSK, BI, Valeant, Lundbeck, TEVA, Roche, Chiesi, and Vernalis.</note><subject lang="en"><genre>Keywords</genre><topic>advanced Parkinson's disease</topic><topic>dyskinesias</topic><topic>motor fluctuations</topic><topic>levodopa</topic><topic>dopamine agonists</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title><subTitle>Official Journal of the Movement Disorder Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Mov. 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