Pharmacokinetic characteristics of agents applied in the treatment of Parkinson's disease

■ Abstract The efforts to treat Parkinson's disease have resulted in the development of numerous medicines, including L-dopa, 3.4-dihydroxyphenylalanine (DOPA) decarboxylase inhibitors, a monoamine oxidase (MAO) inhibitor, catechol-O-methyltransferase (COMT) inhibitors, dopamine receptor agonists, amantadine and anticholinergics. Patients with Parkinson's disease respond to the agents with improvement in disease signs and symptoms. However, the effect of treatment varies greatly between cases. The factors causing individual differences in response comprise pharmacodynamics and pharmacokinetics. The individual pharmacokinetic characteristics of patients vary by around 4-fold. Factors causing pharmacokinetic variations, including food, drug-drug interactions, sympathetic activity and renal function, are evaluated to achieve better results for personalized therapy in the treatment of Parkinson's disease. The safe total dose of dopamine receptor agonists should be investigated to avoid valvulopathy.