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Parkinson's disease: treatment and non-motor features

Published online by Cambridge University Press:  12 June 2012

Graeme JA Macphee  and
David A Stewart
Graeme JA Macphee*
Affiliation:
Department of Medicine for the Elderly/Movement Disorders Clinic, Southern General Hospital/Victoria Infirmary, Glasgow, UK
David A Stewart
Affiliation:
Department of Medicine for the Elderly/Movement Disorders Clinic, Southern General Hospital/Victoria Infirmary, Glasgow, UK
*
Address for correspondence: GJA Macphee, Consultant/Honorary Clinical Senior Lecturer, Department of Medicine for the Elderly/Movement Disorders Clinic, Southern General Hospital, Glasgow G51 4TF. Email: Graeme.Macphee@ggc.scot.nhs.uk
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Summary

This review on Parkinson's disease (PD) considers pharmacological and surgical management and important non-motor symptoms (NMS) such as depression, dementia and sleep disorder. In the absence of a proven neuroprotective drug, therapy remains symptomatic and may be initiated with levodopa or a dopamine agonist or a monoamine oxidase inhibitor. Treatment should be tailored to the individual patient, with patient preference, extent of functional impairment and co-morbidity more important than age per se. As disease progresses, therapy usually becomes more complex and apomorphine, duodopa and surgical intervention may be useful.

NMS may be present at any stage of illness but become more common in severity and frequency with advanced disease, when neuropsychiatric features such as dementia and psychosis dominate the clinical picture. NMS are often unrecognized and undeclared by patients and carers in clinic. Novel agents for treating non-motor features, which are often poorly responsive to dopaminergic therapy, are urgently required.

Keywords

Parkinson's diseasedrug treatmentnon-motor symptoms
Type
Clinical geriatrics
Information
Reviews in Clinical Gerontology , Volume 22 , Issue 4 , November 2012 , pp. 243 - 260
Copyright
Copyright © Cambridge University Press 2012

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