Future Therapeutic Options in Parkinson's Disease

Future symptomatic treatment of Parkinson's disease (PD) must aim to reduce the nonphysiologic pulsatile stimulation of striatal dopamine receptors, produced by most of the currently available dopaminergic drugs. Promising non-dopaminergic compounds include NMDA and AMPA antagonists and drugs acting on 5-HT-2A, α2-adrenergic, and adenosine A2 receptors. A sustained benefit appears to evolve from the early use of MAOB inhibitors, dopaminagonists and perhaps levodopa itself. Novel insight into the pathogenesis of PD beyond mechanisms responsible for nigral dopaminergic cell death is required to develop disease modifying drugs.