Ahlskog J E, Wilkinson J M
Mayo Medical School, Rochester, Minnesota.
Am Fam Physician. 1990 Feb;41(2):574-84.
Carbidopa/levodopa remains the most potent drug for the treatment of Parkinson's disease. Several newer medications may help stabilize and improve such problems as fluctuating responses to the medication, drug-induced dyskinesias and refractory symptoms. Patients with fluctuating responses that do not respond to adjustments in the carbidopa/levodopa dose may benefit from the addition of a direct-acting dopamine agonist, such as pergolide or bromocriptine. While carbidopa/levodopa and the direct-acting dopamine agonists have a proven track record as symptomatic treatment, they probably do not alter the pathologic process underlying this progressive condition. On the other hand, two studies have shown that selegiline might slow the progression of Parkinson's disease, independent of any direct effects on symptoms.
卡比多巴/左旋多巴仍然是治疗帕金森病最有效的药物。几种较新的药物可能有助于稳定和改善诸如对药物反应波动、药物诱发的运动障碍和难治性症状等问题。对卡比多巴/左旋多巴剂量调整无反应的反应波动患者，加用直接作用的多巴胺激动剂（如培高利特或溴隐亭）可能有益。虽然卡比多巴/左旋多巴和直接作用的多巴胺激动剂作为对症治疗有可靠的记录，但它们可能不会改变这种进行性疾病的病理过程。另一方面，两项研究表明，司来吉兰可能会减缓帕金森病的进展，而与对症状的任何直接影响无关。
