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Limitations of current Parkinson's disease therapy

Authors

  • Olivier Rascol MD, PhD,

    Corresponding author
    1. Clinical Investigation Centre and Department of Clinical Pharmacology, Toulouse, University Hospital France
    2. INSERM U455, Toulouse, University Hospital France
    • Laboratory of Clinical Pharmacology, Faculty of Medicine, 37 Allées J. Guesde, 31073 Toulouse Cedex, France
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  • Pierre Payoux MD,

    1. INSERM U455, Toulouse, University Hospital France
    2. Department of Nuclear Medicine, Toulouse, University Hospital France
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  • Fabienne Ory MD,

    1. Clinical Investigation Centre and Department of Clinical Pharmacology, Toulouse, University Hospital France
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  • Joaquim J. Ferreira MD,

    1. Clinical Investigation Centre and Department of Clinical Pharmacology, Toulouse, University Hospital France
    2. Department of Neurology, Lisbon, Portugal
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  • Christine Brefel-Courbon MD,

    1. Clinical Investigation Centre and Department of Clinical Pharmacology, Toulouse, University Hospital France
    2. INSERM U455, Toulouse, University Hospital France
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  • Jean-Louis Montastruc MD, PhD

    1. Clinical Investigation Centre and Department of Clinical Pharmacology, Toulouse, University Hospital France
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Abstract

Levodopa and other dopaminergic medications drastically improve the motor symptoms and quality of life of patients with Parkinson's disease in the early stages of the disease. However, once the “honeymoon” period has waned, usually after a few years of dopaminergic therapy, patients become progressively more disabled despite an ever more complex combination of available antiparkinsonian treatments. Sooner or later, they suffer from “dopa-resistant” motor symptoms (speech impairment, abnormal posture, gait and balance problems), “dopa-resistant” nonmotor signs (autonomic dysfunction, mood and cognitive impairment, sleep problems, pain) and/or drug-related side effects (especially psychosis, motor fluctuations, and dyskinesias). Therefore, the current antiparkinsonian therapy cannot be considered as ideal with regard to both efficacy and safety. Ann Neurol 2003;53 (suppl 3):S3–S15

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