Dopamine receptor agonists in the treatment of advanced Parkinson's disease.

The symptoms of Parkinson's disease (PD) can become increasingly difficult to control as the disease advances. L-dopa is the most efficacious therapy; however, with long-term therapy, motor and non-motor complications develop. There is now accumulating evidence that the progressive pathology of PD, the change in drug pharmaco-dynamics, and the pulsatile manner in which short-acting dopaminergic agents stimulate striatal dopamine receptors combine as key contributing factors to the priming of the basal ganglia for induction of motor complications. Dopamine receptor agonists have been extensively used as add-on therapy to L-dopa to treat motor complications. In this article we review the role of dopamine receptor agonists in the treatment of advanced parkinsonian patients.