Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Parkinson's disease responds rather dramatically to levodopa therapy during the first several years of treatment. With advancing disease, however, symptom control becomes more erratic, and some symptoms may become refractory to treatment. The use of selegiline hydrochloride (Eldepryl) has been proposed to slow the progression of Parkinson's disease; however, current evidence suggests that it is only partially effective at best, and there is no definite proof of a neuroprotective effect. Nonetheless, it is a reasonable treatment choice. Carbidopa-levodopa (Sinemet) remains the foundation of symptomatic treatment of Parkinson's disease. Clinical fluctuations occurring with advancing disease may be at least partially controlled by appropriate adjustments in dosage. A direct-acting dopamine agonist, bromocriptine mesylate (Parlodel) or pergolide mesylate (Permax), can be very helpful as adjunctive therapy to smooth these clinical fluctuations. Excessive intracellular oxidative stress has been proposed as a cause of Parkinson's disease; however, a recent multicenter trial investigating the use of high doses of the antioxidant vitamin E showed it to be ineffective. Whether other forms of nonspecific antioxidant therapy will prove beneficial is open to speculation.
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PMID:Treatment of Parkinson's disease. From theory to practice. 815 48

Dyskinesia is a common adverse effect complicating chronic dopaminergic therapy for Parkinson's disease. Movements are frequently choreic in nature and have been ascribed to overstimulation of "supersensitive" striatal postsynaptic dopamine receptors. Anticholinergic medications, despite some clinical efficacy in Parkinson's disease, have rarely been reported to cause dyskinesia. We report a patient with Parkinson's disease who developed orobuccal dyskinesia while being treated with trihexyphenidyl (Artane). Dyskinesia was observed following the introduction of trihexyphenidyl, resolved with its discontinuation, and reappeared with its reinstitution. Carbidopa-levodopa (Sinemet) alone did not cause dyskinesia but augmented dyskinesia associated with trihexyphenidyl.
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PMID:Orobuccal dyskinesia associated with trihexyphenidyl therapy in a patient with Parkinson's disease. 784 12

A variety of medical treatment strategies have been proposed as a means of slowing the progression of Parkinson's disease. This includes administration of selegiline (deprenyl) therapy, early use of bromocriptine or pergolide, and delay of levodopa therapy or restriction of the dose. There is no compelling evidence supporting the use of any of these treatment strategies for this purpose. Carbidopa-levodopa remains the most potent medication for symptomatic treatment of Parkinson's disease. Although starting levodopa therapy with the controlled-release formulation is advocated, this does not appear to have any major advantages over standard carbidopa-levodopa. Further studies are needed to identify other means of halting the progression of Parkinson's disease.
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PMID:Treatment of early Parkinson's disease: are complicated strategies justified? 865 8

A 67-year-old woman with an 8-year history of Parkinson's disease and Lewy body dementia experienced difficulty in opening her eyelids (apraxia of lid opening [ALO]); she could close them without difficulty. This problem emerged 2 weeks after the patient's dosage of carbidopa 50 mg-levodopa 200 mg 3 times/day was decreased to twice/day. Two weeks after the onset of ALO the patient visited her physician, who suspected carbidopa-levodopa of causing the problem; the drug was discontinued. When the patient's condition worsened rather than improved, she was referred to a neuro-ophthalmologist, who confirmed the diagnosis of ALO. However, the neuro-ophthalmologist noted that this may not have been a true apraxia but rather a form of sustained blepharospasm that prevented the eyelid from opening. Carbidopa-levodopa was restarted, and her condition improved dramatically when her dosage was increased gradually to carbidopa 50 mg-levodopa 200 mg in the morning and at noon, and carbidopa 25 mg-levodopa 100 mg in the evening. Clinicians should be aware of adverse reactions, such as AOL, in patients taking carbidopa-levodopa who have dementia of the Lewy body type.
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PMID:Apraxia of lid opening: dose-dependent response to carbidopa-levodopa. 1504 Jun 54

Carbidopa-levodopa (CD-LD) is the mainstay of treatment for Parkinson's disease (PD), yet most patients with advanced PD develop motor fluctuations with time when treated with CD-LD. Development of longer-acting CD-LD formulations is a major goal for reducing motor fluctuations in advanced PD. IPX066 is a new formulation of CD-LD that contains both an immediate-release and a sustained-release levodopa component, which is currently under review by the US FDA. Recent clinical trials have demonstrated improved effectiveness of IPX066 compared with other CD-LD formulations in advanced PD, with a reduction in 'off' time of approximately 37%. While it has also been shown to be effective in early PD compared with placebo, its role in early PD compared with other available medications for PD is unclear at this time.
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PMID:IPX066: a new intermediate-and extended-release carbidopa-levodopa formulation. 2450 94

Parkinson disease (PD) is a complex neurologic disorder that involves motor and nonmotor brain functions. PD is the second most common neurodegenerative disease after Alzheimer disease. Motor symptoms include resting tremor, cogwheel rigidity, extreme slowness of movement, shuffling gait, and impaired balance. Swallowing and speaking difficulties also are common. Nonmotor symptoms include depression, hallucinations, and sleep disturbances that seriously affect quality of life. There is no cure for PD but management of motor and nonmotor symptoms can improve quality of life. Carbidopa-levodopa is an effective initial treatment for motor symptoms of rigidity and resting tremors. Treatments for nonmotor symptoms include antidepressants, antipsychotics, and drugs for dementia. (This is an off-label use of some antidepressants, antipsychotics, and drugs for dementia.) A multidisciplinary approach to optimizing care can include physical and occupational therapy, speech therapy, and psychological therapy.
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PMID:Neurologic Conditions: Parkinson Disease. 3074 8