PARKINSONS-DISEASE - PROSPECTS FOR IMPROVED DRUG-THERAPY

L-Dopa has long been the mainstay of therapy for Parkinson's disease b ut its long-term shortcomings, principally uncoordinated, spasmodic or irregular movements (dyskinesias) and fluctuating control of motor sy mptoms (on/off fluctuations), are well documented. The postulated neur oprotective properties of L-deprenyl, often used as an adjunct to L-do pa, are under scrutiny and doubts have also been raised regarding its safety. Alternative therapeutic approaches are clearly needed. In this review, Jim Pagan, Derek Middlemiss, Paul Sharpe and George Poste out line some new approaches to treatment, with an emphasis on novel, sele ctive dopamine receptor agonists. In addition, Parkinson's disease is commonly thought to be caused by the neurotoxic effects of an unidenti fied agent but recent data indicate a greater genetic component than p reviously re cognized. Developments in the genetics of Parkinson's dis ease may provide the key to the next generation of therapeutics.