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Chapter 22 - Conventional Pharmacotherapy in Parkinson’s Disease

from Section 2: - Hypokinetic Movement Disorders

Published online by Cambridge University Press:  07 January 2025

By
Erik Ch. Wolters
Edited by
Erik Ch. Wolters  and
Christian R. Baumann
Erik Ch. Wolters
Affiliation:
Universität Zürich
Christian R. Baumann
Affiliation:
Universität Zürich
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Summary

This chapter deals with the pharmacotherapy of motor clinical hallmarks in Parkinson’s disease (PD), plus other PD and/or its intervention-related signs and symptoms. The treatment of PD-related non-dopaminergic symptoms such as mainly autonomic, neuropsychiatric and sleep–wake disorders are extensively dealt with in other chapters, so the pharmacotherapy of these disorders are only be discussed briefly. Autonomic non-motor fluctuations comprise cardiovascular (orthostatic hypotension), urogenital (detrusor over- and underactivity-related problems, e.g., urgency, frequency, nocturia, hesitation and straining), and gastrointestinal manifestations (sialorrhea, dysphagia, delayed gastric emptying, constipation). Depression and (mild) cognitive impairment are the most important mainly direct PD-related neuropsychiatric disorders, whereas impulse control disorders, as well as dementia and psychosis, are frequently seen as dopaminomimetic adverse events. Sleep–wake disorders with parasomnias are also characteristic non-motor symptoms in PD. The tailored pharmacologic strategies in these non-dopaminergic symptoms are discussed in detail.

Keywords

(Non) dopaminergic strategiesglutamate/cholinergic/adenosine 2A receptor antagonistsstrategies in PD-related autonomic/neuropsychiatric/sleep disorders
Type
Chapter
Information
International Compendium of Movement Disorders , pp. 264 - 279
Publisher: Cambridge University Press
Print publication year: 2025

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