Abstract
For many years, levodopa has given most patients with Parkinson's disease excellent symptomatic benefit. This agent does not slow down the progression of the disease, however, and it can induce motor fluctuations and dyskinesias in the long term. The other available antiparkinsonian agents also have drawbacks, and as a consequence research into antiparkinsonian drugs is expected to take new and different directions in the coming years. The most promising approaches include the development of 'neuroprotective' drugs that are capable of blocking or at least slowing down the degenerative process that is responsible for cellular death; 'restorative' strategies intended to restore normal brain function; more-effective agents for replacing dopamine loss; and symptomatic and antidyskinetic drugs that act on neurotransmitters other than dopamine or target brain areas other than the striatum. In this Review, we discuss the numerous drugs in development that target the primary motor disorder in Parkinson's disease.
Key Points
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Several new drugs for neuroprotection in Parkinson's disease are being developed, but human studies have not yet demonstrated a clear disease-modifying effect
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New compounds have been developed that improve levodopa bioavailability and synaptic availability of dopamine
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Novel non-dopaminergic drugs might be useful for their symptomatic antiparkinsonian effects
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Levodopa-induced dyskinesia might also be ameliorated by new drugs acting on the glutamatergic, noradrenergic or serotonergic systems
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Acknowledgements
The authors thank W Poewe and O Rascol for their data about ongoing trials in PD.
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Colosimo, C., Fabbrini, G. & Berardelli, A. Drug Insight: new drugs in development for Parkinson's disease. Nat Rev Neurol 2, 600–610 (2006). https://doi.org/10.1038/ncpneuro0340
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DOI: https://doi.org/10.1038/ncpneuro0340