Parkinson's disease: managing symptoms and preserving function

Abstract

Two strategies of drug therapy for Parkinson's disease (PD) are neuroprotective and symptomatic. In early PD, selegiline may delay need for symptomatic treatment, but whether this represents a delay in disease progression remains controversial. The decision to begin symptomatic therapy depends on how disabling or troublesome symptoms are to the patient. Anticholinergics are often used as monotherapy for alleviation of early tremor. When levodopa is added, it may be reasonable to begin with the controlled-release form. The variety of dopamine agonists used as adjunctive agents is increasing. Research continues on surgical therapies and fetal tissue transplantation.