Pharmacological treatment of Parkinson’s disease

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The main attention in the management of Parkinson's disease is directed on the treatment of motor and non- motor features of the disorder, as well as on the improvement of patient’s overall quality of life. The main strategies for pharmacological therapy include increasing dopamine activity in the brain, decreasing muscarinic cholinergic activity, or both. L-DOPA, used in combination with carbidopa, is the most effective pharmacological agent for PD and remains the gold standard of the primary treatment for symptomatic patients. Dopamine agonists are useful for early PD, highly effective as an adjunctive therapy to L-DOPA in the advanced disease, and furthermore causing a lower tendency for individuals to develop motor complications. MAO-B inhibitors may be used for the treatment of patients with early PD with mild-to-moderate motor features before initiating treatment with LC or DAs, and as an adjuvant for patients with motor fluctuations. As an initial management of PD, MAO-B inhibitors showed similar efficacy as DAs in the treatment of motor symptoms. Numerous non-pharmacological strategies that are used for PD treatment are exercise programs and occupational, physical, and speech therapy, which may provide a clinical benefit when used as an adjunctive treatment.

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pharmacological, treatment, management, Parkinson’s, Parkinson, disease, etiology, pathogenesis, clinical presentation, symptoms, levodopa, DA, dopamine agonists, MAO-B inhibitors, anticholinergics, amantadine, COMT inhibitors, centrally acting muscle relaxants, neuroprotective, non-pharmacological, surgical, comorbid, palliative, L-DOPA
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