Archive | 2019
Medical Therapy for Fluctuations in Parkinson’s Disease
Abstract
Motor/non-motor fluctuations and dyskinesia are common serious late effects of dopaminergic therapy in PD. Risk factors for these complications include age of onset and dose of levodopa. The initial fluctuating pattern is a predictable end-of-dose wearing off, but, with time, variations in response become less predictable. There are many medical options to treat these fluctuations including monoamine oxidase B inhibitors, catechol-O-methyltransferase inhibitors, dopamine agonists (including oral, patch, and injectable forms), amantadine, and several formulations of carbidopa/levodopa (extended release, capsules, intrajejunal gel). I will discuss how these agents can be used to treat the varied forms of response fluctuations and dyskinesia.