Treatment of Parkinson’s Disease

Treatment of Parkinson’s disease (PD) is based on the principle that the deficiency of dopamine in the brain can be countered by administering its natural precursor (levodopa). Apart from this we discussed other oral therapies which can be commenced as monotherapy or adjunctive therapies including MAO-B Inhibitors, COMT Inhibitors, NMDA receptor antagonist, Adenosine A2A receptor antagonist and Dopamine agonists. We explained the rationale of early treatment, strategy of initial treatment, the significance of continuous dopaminergic stimulation, strategy of treatment for advanced PD, and deep brain stimulation as a surgical treatment. We also discussed the side effects and other issues arising from administration of various therapies. We compared various device assisted therapies especially in advanced PD cases and tried to shed some light on choice of each of them under various circumstances. We touch based newer therapies and strategies which are still under investigation.