PHARMACOLOGICAL OPTIONS FOR MANAGING PARKINSONS-DISEASE

Current therapy for idiopathic Parkinson's disease (IPD) is mainly sym ptomatic with the focus on individualizing therapy for early and advan ced. stage disease. The most effective drug for both early and advance d IPD is levodopa, For patients with mild disease and minimal disabili ty, monotherapy with anticholinergic agents, amantadine, selegiline, o r dopamine agonists (eg, bromocriptine and pergolide) may be useful. A dvanced disease is usually associated. with levodopa-induced complicat ions, such as motor fluctuations and dyskinesias, which may be allevia ted by adjusting levodopa dosing or by add lng a dopamine agonist. Alt hough no drug has been unequivocally proven to be neuroprotective in I PD, selegiline, amantadine, bromocriptine, and pergolide may play some role in delaying the progression of disease.