Pharmacological treatment of Parkinson disease: a review.

@article{Connolly2014PharmacologicalTO,
  title={Pharmacological treatment of Parkinson disease: a review.},
  author={Barbara S. Connolly and A. Lang},
  journal={JAMA},
  year={2014},
  volume={311 16},
  pages={
          1670-83
        }
}
IMPORTANCE Parkinson disease is the second most common neurodegenerative disease worldwide. [...] Key MethodEVIDENCE REVIEW References were identified using searches of PubMed between January 1985 and February 2014 for English-language human studies and the full database of the Cochrane Library. The classification of studies by quality (classes I-IV) was assessed using the levels of evidence guidelines from the American Academy of Neurology and the highest-quality data for each topic. Expand

Paper Mentions

Observational Clinical Trial
The purpose of this study is to evaluate how safinamide, rasagiline and other SoC drugs are associated with the quality of life of PD patients by means of the Parkinson's Disease… Expand
ConditionsParkinson's Disease
Interventional Clinical Trial
The purpose of this study is to select the safest and most effective number of repeat doses of allogeneic bone marrow-derived mesenchymal stem cell (MSC) infusions to slow the… Expand
ConditionsParkinson's Disease
InterventionDrug
Interventional Clinical Trial
The study will look into the changes of Deep Brain Stimulation (DBS) measured impedances in patients of Parkinson disease (PD) as a function of their functional state (lying, sitting… Expand
ConditionsParkinson Disease
InterventionOther
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  • J. J. Lee
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  • Journal of the Korean Neurological Association
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Evidence-based review of pharmacological treatment of Parkinson’s disease from early to advanced stages as well as management its unavoidable adverse reactions are provided. Expand
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TLDR
Treatment of PD is multifaceted and requires a tailored pharmacotherapeutic and nonpharmacologic approach for a given patient, and clinicians should try to provide optimum benefit through the many treatment options available. Expand
Initial management of Parkinson’s disease
TLDR
Research is under way to deliver dopaminergic therapy more effectively, but studies aimed at slowing or stopping disease progression have not shown promise. Expand
Cholinesterase inhibitors for Parkinson's disease: a systematic review and meta-analysis
TLDR
A systematic review of prospective, randomised controlled trials found that ChIs are effective in the treatment of cognitive impairment in patients with PD, but do not affect risk of falls. Expand
Pharmacological management of Parkinson’s disease in older people
TLDR
An evidence‐based review of Parkinson’s disease treatments and guidance to improve clinical management and outcomes in older people is presented. Expand
Treatment of Older Parkinson's Disease.
TLDR
Medical management of parkinsonian symptoms should be preferred with levodopa monotherapy, however, in patients with significant motor fluctuations, dopaminergic agents may be added with caution, as they are notorious for several adverse reactions. Expand
Emerging Pharmacotherapies for Motor Symptoms in Parkinson’s Disease
TLDR
Existing and emerging pharmacotherapies for motor symptoms in PD are outlined and newer medications and modes of delivery continue to be researched and added to the therapeutic armamentarium. Expand
Dyskinesias and impulse control disorders in Parkinson's disease: From pathogenesis to potential therapeutic approaches
TLDR
The most relevant advances in relation to imaging, genetics, biochemistry and pharmacological interventions to treat levodopa-induced dyskinesias and impulse control disorders in patients with PD and in animal models are reviewed to better understand the overlapping and unique maladaptations to dopaminergic therapy that are associated with LID and ICD. Expand
Management of Psychosis in Parkinson's Disease: Emphasizing Clinical Subtypes and Pathophysiological Mechanisms of the Condition
TLDR
A literature review on the most recent knowledge with special focus on specific clinical subtypes and pathophysiological mechanisms of PD psychosis will not only contribute to an up to date practical approach of this condition for the health care providers, but furthermore open up new ideas for research in the near future. Expand
Effects of Genetic Variability in Dopaminergic Pathway on Treatment Response in Parkinson’s Disease
TLDR
Several polymorphic genes have already been associated with treatment outcome in PD, such as metabolic enzymes, transport and receptor genes, and might serve as treatment outcome prediction factors and help in personalized care of PD patients to prevent adverse events and inefficacy of a certain drug. Expand
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References

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An update expert opinion on management and research strategies in Parkinson's disease psychosis
TLDR
Novel research strategies focus on nondopaminergic systems and incorporate neuroimaging, genetic associations and animal models and have the potential to enhance understanding of PD psychosis and advance the development of agents that can ultimately be tested in well-designed, randomized, controlled trials. Expand
Impact of standard of care for psychosis in Parkinson disease
TLDR
A group of 26 patients with idiopathic PD, initially referred for participation in a study of quetiapine as a treatment for psychotic symptoms in PD patients, were evaluated using a separate investigator-initiated protocol, finding no previous studies have formally evaluated the validity of this approach. Expand
Treatment of Parkinson disease: a 64-year-old man with motor complications of advanced Parkinson disease.
TLDR
The case of Mr L, a man with an 11-year history of Parkinson disease, illustrates these emerging motor complications and the manner in which they may be managed both medically and surgically. Expand
Management of hallucinations and psychosis in Parkinson's disease.
  • M. Eng, T. Welty
  • Medicine
  • The American journal of geriatric pharmacotherapy
  • 2010
TLDR
Results of the identified studies suggested that patients with PD might benefit from long-term clozapine therapy, while results of the quetiapine studies were conflicting and the significance of the differences in treatment responses between patients with dementia and those without dementia remains unclear. Expand
Practice Parameter: Treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology
TLDR
There is insufficient evidence to support or refute the efficacy of DBS of the GPi or VIM nucleus of the thalamus in reducing off time, dyskinesia, or medication usage, or to improve motor function. Expand
Zonisamide in managing impulse control disorders in Parkinson’s disease
TLDR
It is suggested that ZNS may be effective for ICDs in PD, and the lack of studies with other medications to treat these behaviours in PD and the potential beneficial effects of ZNS for motor complications make this drug important in the treatment of the disease. Expand
Pramipexole for the treatment of depressive symptoms in patients with Parkinson's disease: a randomised, double-blind, placebo-controlled trial
TLDR
Pramipexole improved depressive symptoms in patients with Parkinson's disease, mainly through a direct antidepressant effect. Expand
Atomoxetine for depression and other neuropsychiatric symptoms in Parkinson disease
TLDR
This interventional study provides Class II evidence that atomoxetine (target dosage = 80 mg/day) is not efficacious in improving clinically significant depression in PD, but was associated with improvement in global cognitive performance and daytime sleepiness. Expand
The Movement Disorder Society Evidence‐Based Medicine Review Update: Treatments for the motor symptoms of Parkinson's disease
TLDR
The objective was to update previous evidence‐based medicine reviews of treatments for motor symptoms of Parkinson's disease published between 2002 and 2005 and highlights gaps for research. Expand
A controlled trial of antidepressants in patients with Parkinson disease and depression
TLDR
The trial suggests that depression in patients with PD is responsive to treatment and raises questions about the relative efficacy of dual reuptake inhibitors and selective serotonin reuptakes inhibitors. Expand
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