Treatment of Parkinson’s Disease: Early, Late, and Combined

M. Beudel, R. M.A. de Bie, K. L. Leenders*

*Bijbehorende auteur voor dit werk

    OnderzoeksoutputAcademicpeer review

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    Medical therapy in de novo Parkinson’s disease typically starts with a dopamine agonist or levodopa in combination with a decarboxylase inhibitor or if symptoms are still very mild with a MAO-B inhibitor. When patients do not (or no longer) respond satisfactorily to these initial therapies, different drugs can be initiated or combined (i.e., “add-on” treatments). These add-on therapies not only comprise oral agents but also intra-jejunal and intra-cutaneous treatments and functional neurosurgical procedures. This chapter starts with the treatment of de novo Parkinson’s disease whereafter indications and expected effects of the different “add-on” therapies will be described. The “add-on” therapies will be described in a hierarchical way and treatment algorithms will be provided based on prevailing symptoms including non-motor symptoms. The symptoms that will be discussed are: (1) bradykinesia and “wearing-OFF, " (2) tremor at rest, (3) dyskinesia, (4) gait and postural symptoms including freezing of gait, and (5) important non-motor symptoms. Finally, a comprehensive add-on treatment algorithm will be provided that takes into account non-motor symptoms that may limit the efficacy and tolerability of the different add-on therapies.

    Originele taal-2English
    TitelNeuroPsychopharmacotherapy
    RedacteurenPeter Riederer, Gerd Laux, Toshiharu Nagatsu, Weidong Le, Christian Riederer
    UitgeverijSpringer International Publishing AG
    Pagina's2891-2915
    Aantal pagina's25
    ISBN van elektronische versie9783030620592
    ISBN van geprinte versie9783030620585
    DOI's
    StatusPublished - 1-jan.-2022

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