Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King's College London , London, UK.
Parkinson's Foundation Centre of Excellence, King's College Hospital , London, UK.
Expert Rev Neurother. 2020 Sep;20(9):953-965. doi: 10.1080/14737175.2020.1806059. Epub 2020 Sep 15.
Dopamine agonists have been widely used to treat patients with Parkinson's disease, but concerns related to their well-known side effects might prevent their use even when indicated. In this review, the authors describe for the first time the concept of 'Dopamine Agonist Phobia', a pharmacophobia that the authors believe might affect clinicians, and they provide evidence of the benefits of dopamine agonists, focusing on non-motor symptoms.
The authors performed an extensive literature research, including studies exploring the use of dopamine agonists for the treatment of non-motor symptoms. The authors indicate the highest level of evidence in each section.
'Dopamine Agonist Phobia' may preclude valid therapeutic options in selected cases, specifically for the treatment of non-motor symptoms. Thus, the authors propose a personalized approach in Parkinson's disease treatment, and encourage a thoughtful use of dopamine agonists, rather than an overall nihilism.
多巴胺激动剂已被广泛用于治疗帕金森病患者,但由于其众所周知的副作用,即使在适应证下,也可能会阻碍其使用。在这篇综述中,作者首次描述了“多巴胺激动剂恐惧症”的概念,这是一种作者认为可能会影响临床医生的药物恐惧症,并提供了多巴胺激动剂的益处证据,重点关注非运动症状。
作者进行了广泛的文献研究,包括探索多巴胺激动剂治疗非运动症状的研究。作者在每个部分都指出了最高级别的证据。
“多巴胺激动剂恐惧症”可能会排除特定情况下(特别是治疗非运动症状时)的有效治疗选择。因此,作者提出了一种帕金森病治疗的个性化方法,并鼓励深思熟虑地使用多巴胺激动剂,而不是一概而论地否定。