Practice Parameter: Treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): [RETIRED]

Pahwa, Rajesh; Factor, Stewart A.; Lyons, Kelly E.; Ondo, William G.; Gronseth, Gary S.; Brontë‐Stewart, Helen; Hallett, Mark; Miyasaki, Janis; Stevens, J. Clarke; Weiner, William J.

doi:10.1212/01.wnl.0000215250.82576.87

Cited by 458 publications

(325 citation statements)

References 62 publications

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“…Conventional antiparkinsonism drugs effectively ameliorate the symptoms of patients with PD during the initial several years of onset, but become increasingly less effective and induce motor fluctuations including wearing-off, on-off, dopa-induced dyskinesia, and agonist-induced sleep attack (Arnulf et al, 2002;Comella, 2002;Hobson et al, 2002;Ondo et al, 2001;Pahwa et al, 2006 Smet, 2002). Traditional Chinese medicines (TCM) ameliorate various symptoms, particularly the ageing-related symptoms, and hence are likely to be beneficial for chronic diseases such as PD (Iwasaki et al, 2004;2005a;2005b).…”

Section: Evaluation Of Effects Of Traditional Chinese Medicine On Parmentioning

confidence: 99%

Objective Evaluation of the Severity of Parkinsonism Using Power-Law Temporal Auto-Correlation of Activity

Pan¹,

Yamamoto²,

Kwak³

2011

Diagnostics and Rehabilitation of Parkinson's Disease

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Section: Evaluation Of Effects Of Traditional Chinese Medicine On Parmentioning

confidence: 99%

Objective Evaluation of the Severity of Parkinsonism Using Power-Law Temporal Auto-Correlation of Activity

Pan¹,

Yamamoto²,

Kwak³

2011

Diagnostics and Rehabilitation of Parkinson's Disease

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“…However, there is still no consensus on exactly how such treatment should be administered. Evidence‐based reviews conclude that there are different well‐documented treatment strategies, but there is no evidence that one strategy should be chosen over another 7, 8, 9, 10, 11, 12, 75. Therefore, it is important to treat each patient individually.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, most treatment strategies also aim at delaying the evolvement of motor fluctuations as long as possible. Various treatment recommendations and guidelines are available, from individual authors and from national and international associations and specialist groups 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19. Some of these are evidence based, like the recently published national guidelines from Germany and Sweden,18, 19 while many others are based on consensus in expert groups.…”

Section: Introductionmentioning

confidence: 99%

Algorithms for the treatment of motor problems in Parkinson's disease

Dietrichs

Odin

2017

Acta Neurol Scand

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Several different strategies are effective for medical treatment of motor problems in Parkinson's disease (PD). Many guidelines and evidence‐based reviews are available, but there is no documentation or consensus in favor of just one treatment strategy. This review presents two algorithms that may be helpful when deciding how to treat a PD patient at various stages of the disease. The first algorithm suggests one way to treat PD from the first onset of motor symptoms. It is largely based on treatment recommendations from the Scandinavian countries and Germany. The other algorithm is meant as assistance for choosing among the different device‐aided treatments for advanced PD. There is not sufficient comparative data to recommend one particular line of treatment, neither in early PD nor in advanced disease with motor complications. Individualized treatment is needed for each patient. The current algorithms only represent an alternative for aiding treatment decisions.

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“…Practice guidelines from the American Academy of Neurology indicate that the evidence supports many options. 24,134 Several key adverse events received significant attention in recent years and can be summarized in the following manner: melanoma (along with other skin cancers) may occur at an increased rate in PD, but there is no evidence to connect it causally with LD. Modest elevations of homocysteine have been seen with LD, but the importance has yet to be determined.…”

Section: Discussionmentioning

confidence: 99%

Current Status of Symptomatic Medical Therapy in Parkinson’s Disease

Factor

2008

Neurotherapeutics

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Summary: Symptomatic medical therapies for Parkinson's disease (PD) have been disease modifying and have led to improvement in daily function, quality of life, and survival. For 40 years, these therapies have been primarily dopaminergic, and currently include the dopamine (DA) precursor levodopa (LD), DA agonists, catechol-O-methyltransferase (COMT) inhibitors, and monoamine oxidase (MAO) inhibitors. The roles of all these classes of agents have evolved, with significant changes occurring since the early 2000s. This article reviews the current literature for each of these classes of drugs, with a focus on efficacy and place in the therapeutic scheme. Levodopa is no longer considered to be toxic and, thus, its early use is not only appropriate but recommended.Ergot agonists are no longer in use, and new agents administered in patch form or subcutaneous injections have been approved. The COMT inhibitor tolcapone, with its significant efficacy, has been reintroduced, and two new MAO inhibitors have been approved. Selected safety issues are discussed, including the incidence of melanoma in relation to LD; pathological gambling and DA agonists; hepatic toxicity of tolcapone; and the tyramine or so-called cheese reaction with MAO B inhibitors. The article closes with a discussion of future directions and new drugs under development.

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Practice Parameter: Treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): [RETIRED]

Abstract: Abstract-Objective:To make evidence-based treatment recommendations for the medical and surgical treatment of patients with Parkinson disease (PD) with levodopa-induced motor fluctuations and dyskinesia. To that end, five questions were addressed.

Cited by 458 publications

References 62 publications

Objective Evaluation of the Severity of Parkinsonism Using Power-Law Temporal Auto-Correlation of Activity

Objective Evaluation of the Severity of Parkinsonism Using Power-Law Temporal Auto-Correlation of Activity

Algorithms for the treatment of motor problems in Parkinson's disease

Current Status of Symptomatic Medical Therapy in Parkinson’s Disease

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