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Therapy of Patients With Parkinson's Disease

Therapy of Patients With Parkinson's Disease Abstract There are few conditions that have more significance for rational practice and neurologic science than does Parkinson's disease (PD), and PD remains in the forefront in discussions of abiotrophy and degeneration, dementia and cognition, animal models and receptors, and genetic and environmental causation, as well as in the discussion of protective, symptomatic, and surgical therapy. One apparent advance since levodopa revolutionized therapy is special interest in movement disorders by many neurologists. Most general neurologists are now skilled at, or at least fascinated by, disorders of movement. Neurologists may feel not just adequately informed but actually bombarded by clinical reports, pharmaceutically sponsored symposia, and definitive experts. Nevertheless, puzzles in the diagnosis of PD, uncertainty in choice of therapy, unsatisfactory results of long-term management, and end-stage despair remain common experiences for us all. What drug to start, what to avoid, what to combine, and how to follow up the patient are not References 1. Quality Standards Subcommittee. Practice parameters: initial therapy of Parkinson's disease . Neurology . 1993;43:1296-1297.Crossref 2. Lang AE, Fahn S. Assessment of Parkinson's disease . In: Munsat TL, ed. Quantification of Neurological Deficit . Stoneham, Mass: Butterworths; 1989:285-309. 3. Butzer JF, Silver DE, Saks AL. Amantadine in Parkinson's disease: a double-blind, placebo-controlled cross-over study with long-term follow up . Neurology . 1975;25:603-606.Crossref 4. The Parkinson Study Group. Effect of deprenyl on the progression of disability in early Parkinson's disease . N Engl J Med . 1989;321:1364-1371.Crossref 5. The Parkinson Study Group. Effects of tocopherol and deprenyl on the progression of disability in early Parkinson's disease . N Engl J Med . 1993:328: 176-183. 6. Melamed E. Initiation of levodopa therapy in parkinsonian patients should be delayed until the advanced stages of the disease . Arch Neurol . 1986;43:402-405.Crossref 7. Fahn S, Bressman SB. Should levodopa therapy for parkinsonism be started early or late? evidence against early treatment . Can J Neurol Sci . 1984;11: 200-206. 8. Olanow CW. A rationale for dopamine agonists as primary therapy for Parkinson's disease . Can J Neurol Sci . 1992;19:108-112. 9. Rinne UK. Early combination of bromocriptine and levodopa in the treatment of Parkinson's disease: a 5-year follow up . Neurology . 1987;37:826-828.Crossref 10. Markham CH, Diamond SG. Evidence to support early levodopa therapy in Parkinson's disease . Neurology . 1981;31:125-131.Crossref 11. Blin J, Bonnet AM, Agid Y. Does levodopa aggravate Parkinson's disease? Neurology . 1988;38:1410-1416.Crossref 12. Cedarbaum JM, Gandy SE, McDowell FH. 'Early' initiation of levodopa treatment does not promote the development of motor response fluctuations, dyskinesias, or dementia in Parkinson's disease . Neurology . 1991;41:622-629.Crossref 13. Weiner WJ, Factor SA, Sanchez-Ramas JR. Early combination therapy (bromocriptine and levodopa) does not prevent motor fluctuations in Parkinson's disease . Neurology . 1993;43:21-27.Crossref 14. Friedman JH, Lannon MC. Clozapine in the treatment of psychosis in Parkinson's disease . Neurology . 1989;39:1219-1221.Crossref 15. Melamed E. Early morning dystonia: a late side-effect of long-term l-dopa therapy in Parkinson's disease . Arch Neurol . 1979;36:308-310.Crossref 16. Nutt JG. Levodopa induced dyskinesia: review, observations, and speculations . Neurology . 1990;40:340-345.Crossref 17. Varon J, Jacobs MB. Treating the progressive stages of Parkinson's disease . Postgrad Med . 1991;90:63-66, 69-71. 18. Faber R, Trimble MR. Electroconvulsive therapy in Parkinson's disease and other movement disorders . Mov Disord . 1991;6:293-303.Crossref 19. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases . J Neurol Neurosurg Psychiatry . 1992;55:181-184.Crossref 20. Jankovic J. Progressive supranuclear palsy . Neurol Clin . 1984;2:473-486. 21. Pincus JH, Barry KM. Influence of dietary protein on motor fluctuations in Parkinson's disease . Arch Neurol . 1987;44:1000-1009. 22. Hutton JT, Morris JL, Roman GC, Imke SC, Elias JW. Treatment of chronic Parkinson's disease with controlled-release carbidopa/levodopa . Arch Neurol . 1988;45:861-864.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Therapy of Patients With Parkinson's Disease

Paulson, George W.
Archives of Neurology , Volume 51 (8) – Aug 1, 1994
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References (26)

Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1994.00540200028012
Publisher site
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Abstract

Abstract There are few conditions that have more significance for rational practice and neurologic science than does Parkinson's disease (PD), and PD remains in the forefront in discussions of abiotrophy and degeneration, dementia and cognition, animal models and receptors, and genetic and environmental causation, as well as in the discussion of protective, symptomatic, and surgical therapy. One apparent advance since levodopa revolutionized therapy is special interest in movement disorders by many neurologists. Most general neurologists are now skilled at, or at least fascinated by, disorders of movement. Neurologists may feel not just adequately informed but actually bombarded by clinical reports, pharmaceutically sponsored symposia, and definitive experts. Nevertheless, puzzles in the diagnosis of PD, uncertainty in choice of therapy, unsatisfactory results of long-term management, and end-stage despair remain common experiences for us all. What drug to start, what to avoid, what to combine, and how to follow up the patient are not References 1. Quality Standards Subcommittee. Practice parameters: initial therapy of Parkinson's disease . Neurology . 1993;43:1296-1297.Crossref 2. Lang AE, Fahn S. Assessment of Parkinson's disease . In: Munsat TL, ed. Quantification of Neurological Deficit . Stoneham, Mass: Butterworths; 1989:285-309. 3. Butzer JF, Silver DE, Saks AL. Amantadine in Parkinson's disease: a double-blind, placebo-controlled cross-over study with long-term follow up . Neurology . 1975;25:603-606.Crossref 4. The Parkinson Study Group. Effect of deprenyl on the progression of disability in early Parkinson's disease . N Engl J Med . 1989;321:1364-1371.Crossref 5. The Parkinson Study Group. Effects of tocopherol and deprenyl on the progression of disability in early Parkinson's disease . N Engl J Med . 1993:328: 176-183. 6. Melamed E. Initiation of levodopa therapy in parkinsonian patients should be delayed until the advanced stages of the disease . Arch Neurol . 1986;43:402-405.Crossref 7. Fahn S, Bressman SB. Should levodopa therapy for parkinsonism be started early or late? evidence against early treatment . Can J Neurol Sci . 1984;11: 200-206. 8. Olanow CW. A rationale for dopamine agonists as primary therapy for Parkinson's disease . Can J Neurol Sci . 1992;19:108-112. 9. Rinne UK. Early combination of bromocriptine and levodopa in the treatment of Parkinson's disease: a 5-year follow up . Neurology . 1987;37:826-828.Crossref 10. Markham CH, Diamond SG. Evidence to support early levodopa therapy in Parkinson's disease . Neurology . 1981;31:125-131.Crossref 11. Blin J, Bonnet AM, Agid Y. Does levodopa aggravate Parkinson's disease? Neurology . 1988;38:1410-1416.Crossref 12. Cedarbaum JM, Gandy SE, McDowell FH. 'Early' initiation of levodopa treatment does not promote the development of motor response fluctuations, dyskinesias, or dementia in Parkinson's disease . Neurology . 1991;41:622-629.Crossref 13. Weiner WJ, Factor SA, Sanchez-Ramas JR. Early combination therapy (bromocriptine and levodopa) does not prevent motor fluctuations in Parkinson's disease . Neurology . 1993;43:21-27.Crossref 14. Friedman JH, Lannon MC. Clozapine in the treatment of psychosis in Parkinson's disease . Neurology . 1989;39:1219-1221.Crossref 15. Melamed E. Early morning dystonia: a late side-effect of long-term l-dopa therapy in Parkinson's disease . Arch Neurol . 1979;36:308-310.Crossref 16. Nutt JG. Levodopa induced dyskinesia: review, observations, and speculations . Neurology . 1990;40:340-345.Crossref 17. Varon J, Jacobs MB. Treating the progressive stages of Parkinson's disease . Postgrad Med . 1991;90:63-66, 69-71. 18. Faber R, Trimble MR. Electroconvulsive therapy in Parkinson's disease and other movement disorders . Mov Disord . 1991;6:293-303.Crossref 19. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases . J Neurol Neurosurg Psychiatry . 1992;55:181-184.Crossref 20. Jankovic J. Progressive supranuclear palsy . Neurol Clin . 1984;2:473-486. 21. Pincus JH, Barry KM. Influence of dietary protein on motor fluctuations in Parkinson's disease . Arch Neurol . 1987;44:1000-1009. 22. Hutton JT, Morris JL, Roman GC, Imke SC, Elias JW. Treatment of chronic Parkinson's disease with controlled-release carbidopa/levodopa . Arch Neurol . 1988;45:861-864.Crossref

Journal

Archives of Neurology – American Medical Association

Published: Aug 1, 1994

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