Department of Neurology, Harvard Medical School, Parkinson's Disease and Movement Disorders Center, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA.
Curr Treat Options Neurol. 2013 Aug;15(4):377-84. doi: 10.1007/s11940-013-0236-7.
This is an update to an article published in this journal in 2006, which covered the initial treatment of Parkinson's disease (PD). In this update, we review new research into symptomatic treatments, potential disease modifying ("neuroprotective") agents, and evidence-based reviews of current treatment. We discuss the usage of the MAO-B inhibitors, including the controversy surrounding the possible neuroprotective effects of rasagiline. Usage of extended release formulations of pramipexole and ropinirole, as well as the transdermal dopamine agonist rotigotine, are reviewed. Side effects of the dopamine agonists are discussed, including the cardiac side effects of ergot-derived dopamine agonists, and the impulse control disorders associated with the dopamine agonists. The use of zonisamide as an agent for PD tremor is reviewed. We touch on the clinical research into the benefits of exercise in PD, and briefly review some of the current studies for new formulations of levodopa and other medications and treatments with novel mechanisms of action.
这是本刊 2006 年发表的一篇关于帕金森病（PD）初始治疗的文章的更新。在本次更新中，我们回顾了针对症状性治疗、潜在的疾病修饰（“神经保护”）药物的新研究，以及对当前治疗方法的循证综述。我们讨论了 MAO-B 抑制剂的使用，包括围绕雷沙吉兰可能的神经保护作用的争议。还回顾了普拉克索和罗匹尼罗的缓释制剂以及透皮多巴胺激动剂罗替高汀的使用。讨论了多巴胺激动剂的副作用，包括麦角衍生的多巴胺激动剂的心脏副作用，以及与多巴胺激动剂相关的冲动控制障碍。还介绍了佐尼沙胺作为 PD 震颤的治疗药物。我们提到了 PD 运动益处的临床研究，并简要回顾了一些针对左旋多巴和其他药物新配方以及具有新作用机制的治疗方法的当前研究。
