Entacapon zur Therapie der motorischen Fluktuationen bei idiopathischem Parkinson-Syndrom

Sommer, Ulrich; Müller, A.; Herting, B.; Cormann, K.; Kohlert, F.; Reichmann, Heinz

doi:10.1007/s00115-002-1354-8

Cited by 1 publication

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References 12 publications

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“…Recent short term studies have shown that the addition of entacapone to levodopa improves its efficacy in patients with fluctuations and reduces wearing off and end of dose akinesia. [33][34][35] Some authorities have suggested a combination of levodopa and COMT inhibitors to be used from the outset in the management of Parkinson's disease. 36 However, long term studies using COMT inhibitors with levodopa are awaited.…”

Section: Management Of Long Term Motor Complications Of Levodopamentioning

confidence: 99%

Long term motor complications of levodopa: clinical features, mechanisms, and management strategies

Thanvi

Lo²

2004

Postgraduate Medical Journal

156

110

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Levodopa is the most effective symptomatic treatment of Parkinson’s disease. However, after an initial period of dramatic benefit, several limitations become apparent including, “dopa resistant” motor symptoms (postural abnormalities, freezing episodes, speech impairment), “dopa resistant” non-motor signs (autonomic dysfunction, mood and cognitive impairment, etc), and/or drug related side effects (especially psychosis, motor fluctuations, and dyskinesias). Motor complications include fluctuations, dyskinesias, and dystonias. They can be very disabling and difficult to treat. Therefore, strategies should ideally be developed to prevent them. Though mechanisms underlying motor complications are only partially understood, recent work has revealed the importance of pulsatile stimulation of postsynaptic dopamine receptors and the disease severity. As a result of intermittent stimulation there occurs a cascade of changes in cell signalling leading to upregulation of the N-methyl-D-aspartate subtype of gamma-aminobutryric acid-ergic neurones. Modified preparations of levodopa (controlled release preparations, liquid levodopa), catecholamine-o-methyltransferase inhibitors, dopamine agonists, amantidine, and various neurosurgical approaches have been used in the prevention and/or treatment of motor complications. Current management of motor complications is less than satisfactory. With better understanding of the pathogenetic mechanisms, it is hoped that future therapeutic strategies will provide a safer and targeted treatment.

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Section: Management Of Long Term Motor Complications Of Levodopamentioning

confidence: 99%