Treatment for Parkinson Disease

parkinsonism accounts for about 15 percent of all medical visits and accounts for 50 percent of all hospital admissions. Although some causes of parkinsonism are largely unknown, most instances of parkinsonism are hypothesized to be idiopathic. An estimated 4 million Americans suffer parkinsonism and its features.

L-DOPA is generally recommended to treat PD. In clinical studies, this treatment was shown to improve motor functions without affecting pain or tolerability. A reduction in the number of side-effects suggests a potential protective effect on the developing dopaminergic synapses. Moreover, a small proportion of patients benefited from the treatment, although these patients were found to benefit slightly or not at all on motor functions. These effects were maintained long-term and were possibly due to the long-term improvement of motor functions. In contrast, L-DOPA was less effective on cognition. Further studies seem to be worthwhile to clarify the exact effectiveness of L-DOPA and to evaluate the potential protective effects on neurons and the possible maintenance of the obtained neuroprotection.

It appears that in the early stages of Parkinson's disease there are different pathologic mechanisms of substantia nigra degeneration in the left and right. Although the degeneration may be triggered by the same pathological mechanism, the clinical course is different, thus reflecting the involvement of different factors of the system.

Impaired balance, speech, gait initiation and abnormal finger dexterity are some of the signs of Parkinson's disease. Abnormal sleep or daytime walking, difficulty swallowing and voice abnormalities are also reported signs of parkinsonian disorders.

The main focus of the chapter is Parkinson's disease, a neurodegenerative disease characterized by bilateral tremors and postural instability, and also nonmotor symptoms like cognitive and behavioral disturbances. Other forms of Parkinson's disease, like early onset, familial, and early onset non-surgical are also discussed. Other parkinsonian disorders, like multiple system atrophy, are reviewed here as well. As is shown with a short history, Parkinson's disease is a complex disease with a wide span of symptoms and prognosis. Finally Parkinson's disease is the first disorder that causes Lewy bodies, which are a core protein in the parkinsonian disease brain that characterize this disease.

Common treatment for PDs includes dopamine agonists, dopa decarboxylase inhibitors, anticholinergics and L-dopa. It is important to remember that while dopa decarboxylase inhibitors and dopamine agonists are usually used in the short term to manage motor symptoms, there is no cure for Parkinson's disease and long-term treatment is often needed.

The two main hypotheses can explain why the age of onset of parkinsonian disorders ranges between 30 and 80 years. The first hypothesis suggests that genetic factors have a decisive role. The second hypothesis explains the lack of correlation between the degree of severity and the age of onset of parkinsonian disorders. The third hypothesis suggests an unknown trigger that would initiate the process of neuronal degeneration.

The study showed that common side effects of levodopa/carbidopa and pramipexole are dizziness, headache, orthostatic hypotension, dyslipidemia, fatigue, headache, dizziness, sweating, constipation, depression, weakness, dizziness, drowsiness, urinary incontinence, cough, dyspepsia, flatulence, hypertension, constipation, dysdiarrhea, nausea and hypersalivation. Drugs taken with antipsychotic agents have also been shown to have significant side effects, such as weight gain, dry mouth, dry eyes, fatigue, blurred vision, urinary retention, dyspepsia, constipation and abdominal pain.

The majority of patients receiving treatment typically used with other treatments. Therefore, a structured approach of using multiple treatment options with other treatments is recommended in order to improve the outcomes.

The use of [Dopaminergic agonists] for the initiation of therapy was safe for patients in this study. They did not compromise neuropsychological test scores in either direction. The combination of [Dopaminergic agonists] and L-DOPA resulted in a loss of balance in both directions, which might be expected because these drugs were not used on the same day of testing. Although there are no reliable measures of the extent of dopamine-induced cognitive deficits in PD, changes in mental status, such as cognitive deficits, may be monitored in studies using dopaminergic drugs to assess the safety of such treatments.

This review provides an overview of recently published research on the clinical efficacy and safety of some commonly used dopaminergic agonists and dopaminergic inhibitors in Parkinson's disease.