Abstract
Fluctuations (wearing-off, on off phenomenon, dyskinesias) are a big challenge in the long term treatment of parkinsonian patients. We describe the current strategies for prevention and treatment of fluctuations. Special emphasis is put on two new methods which will soon be available. The new dopamine agonist Rotigotine (Neupro) can be transdermally applied. This is a rather simple way to achieve a continuous dopaminergic stimulation. The same goal is achieved by direct application of levodopa-/carbidopa-gelsuspension (Duodopa) in the duodenum by the help of an electronic pump.
MeSH terms
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Antiparkinson Agents / administration & dosage*
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Antiparkinson Agents / adverse effects
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Apomorphine / administration & dosage
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Apomorphine / adverse effects
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Carbidopa / administration & dosage
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Carbidopa / adverse effects
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Catechol O-Methyltransferase Inhibitors
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Deep Brain Stimulation*
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Dopamine Agonists / administration & dosage
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Dopamine Agonists / adverse effects
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Drug Administration Routes
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Drug Combinations
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Dyskinesia, Drug-Induced / diagnosis
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Dyskinesia, Drug-Induced / therapy
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Humans
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Infusion Pumps, Implantable
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Levodopa / administration & dosage
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Levodopa / adverse effects
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Monoamine Oxidase Inhibitors / administration & dosage
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Monoamine Oxidase Inhibitors / adverse effects
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Neurologic Examination / drug effects
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Parkinson Disease / diagnosis
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Parkinson Disease / therapy*
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Treatment Outcome
Substances
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Antiparkinson Agents
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Catechol O-Methyltransferase Inhibitors
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Dopamine Agonists
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Drug Combinations
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Monoamine Oxidase Inhibitors
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carbidopa, levodopa drug combination
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Levodopa
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Carbidopa
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Apomorphine