Parkinson's disease medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
The mainstay of therapy for motor symptoms of Parkinson disease are: | The mainstay of therapy for motor symptoms of Parkinson disease are: | ||
* Levodopa: | * Levodopa | ||
*<nowiki/>Dopamine agonists | |||
* Monoamine oxidase (MAO) B inhibitors | |||
* Anticholinergic agents | |||
* Amantadine: [[Amantadine]] | |||
* Catechol-O-methyl transferase (COMT) inhibitors | |||
* Estrogen | |||
* | * Other drugs such as [[Exenatide]]<ref name="pmid18492290">{{cite journal |vauthors=Harkavyi A, Abuirmeileh A, Lever R, Kingsbury AE, Biggs CS, Whitton PS |title=Glucagon-like peptide 1 receptor stimulation reverses key deficits in distinct rodent models of Parkinson's disease |journal=J Neuroinflammation |volume=5 |issue= |pages=19 |date=May 2008 |pmid=18492290 |pmc=2426681 |doi=10.1186/1742-2094-5-19 |url=}}</ref>, [[uric acid]]<ref name="pmid19822770">{{cite journal |vauthors=Ascherio A, LeWitt PA, Xu K, Eberly S, Watts A, Matson WR, Marras C, Kieburtz K, Rudolph A, Bogdanov MB, Schwid SR, Tennis M, Tanner CM, Beal MF, Lang AE, Oakes D, Fahn S, Shoulson I, Schwarzschild MA |title=Urate as a predictor of the rate of clinical decline in Parkinson disease |journal=Arch. Neurol. |volume=66 |issue=12 |pages=1460–8 |date=December 2009 |pmid=19822770 |pmc=2795011 |doi=10.1001/archneurol.2009.247 |url=}}</ref>, [[isradipine]]<ref name="pmid21515375">{{cite journal |vauthors=Ilijic E, Guzman JN, Surmeier DJ |title=The L-type channel antagonist isradipine is neuroprotective in a mouse model of Parkinson's disease |journal=Neurobiol. Dis. |volume=43 |issue=2 |pages=364–71 |date=August 2011 |pmid=21515375 |pmc=3235730 |doi=10.1016/j.nbd.2011.04.007 |url=}}</ref>, [[nilotinib]]<ref name="pmid27434298">{{cite journal |vauthors=Wyse RK, Brundin P, Sherer TB |title=Nilotinib - Differentiating the Hope from the Hype |journal=J Parkinsons Dis |volume=6 |issue=3 |pages=519–22 |date=July 2016 |pmid=27434298 |pmc=5044778 |doi=10.3233/JPD-160904 |url=}}</ref> and [[GDNF]] infusion<ref name="pmid12669033">{{cite journal |vauthors=Gill SS, Patel NK, Hotton GR, O'Sullivan K, McCarter R, Bunnage M, Brooks DJ, Svendsen CN, Heywood P |title=Direct brain infusion of glial cell line-derived neurotrophic factor in Parkinson disease |journal=Nat. Med. |volume=9 |issue=5 |pages=589–95 |date=May 2003 |pmid=12669033 |doi=10.1038/nm850 |url=}}</ref> | ||
Treatment choices for some of the nonmotor symptoms of PD are: | Treatment choices for some of the nonmotor symptoms of PD are: | ||
* | * Psychosi<nowiki/>s: Drugs such as [[quetiapine|quet]]<nowiki/>[[quetiapine|iapine]], [[clozapine]] and [[pimavanserin]] are u<nowiki/>sed in managing [[psychosis]] in [[Parkinson's disease|PD]].<ref name="pmid21179595">{{cite journal |vauthors=Shotbolt P, Samuel M, David A |title=Quetiapine in the treatment of psychosis in Parkinson's disease |journal=Ther Adv Neurol Disord |volume=3 |issue=6 |pages=339–50 |date=November 2010 |pmid=21179595 |pmc=3002640 |doi=10.1177/1756285610389656 |url=}}</ref><ref name="pmid24183563">{{cite journal |vauthors=Cummings J, Isaacson S, Mills R, Williams H, Chi-Burris K, Corbett A, Dhall R, Ballard C |title=Pimavanserin for patients with Parkinson's disease psychosis: a randomised, placebo-controlled phase 3 trial |journal=Lancet |volume=383 |issue=9916 |pages=533–40 |date=February 2014 |pmid=24183563 |doi=10.1016/S0140-6736(13)62106-6 |url=}}</ref> one of the [[side effects]] of [[clozapine]] is [[leukopenia]] and [[agranulocytosis]].<ref name="pmid16595571">{{cite journal |vauthors=Schulte P |title=Risk of clozapine-associated agranulocytosis and mandatory white blood cell monitoring |journal=Ann Pharmacother |volume=40 |issue=4 |pages=683–8 |date=April 2006 |pmid=16595571 |doi=10.1345/aph.1G396 |url=}}</ref> | ||
* Dementia: [[Cholinesterase inhibitors]] such as [[rivastigmine]] and [[donepezil]] are the main treatment of [[dementia]] in [[Parkinson's disease|PD]].<ref name="pmid22419314">{{cite journal |vauthors=Rolinski M, Fox C, Maidment I, McShane R |title=Cholinesterase inhibitors for dementia with Lewy bodies, Parkinson's disease dementia and cognitive impairment in Parkinson's disease |journal=Cochrane Database Syst Rev |volume= |issue=3 |pages=CD006504 |date=March 2012 |pmid=22419314 |doi=10.1002/14651858.CD006504.pub2 |url=}}</ref><ref name="pmid15590953">{{cite journal |vauthors=Emre M, Aarsland D, Albanese A, Byrne EJ, Deuschl G, De Deyn PP, Durif F, Kulisevsky J, van Laar T, Lees A, Poewe W, Robillard A, Rosa MM, Wolters E, Quarg P, Tekin S, Lane R |title=Rivastigmine for dementia associated with Parkinson's disease |journal=N. Engl. J. Med. |volume=351 |issue=24 |pages=2509–18 |date=December 2004 |pmid=15590953 |doi=10.1056/NEJMoa041470 |url=}}</ref><ref name="pmid22915447">{{cite journal |vauthors=Dubois B, Tolosa E, Katzenschlager R, Emre M, Lees AJ, Schumann G, Pourcher E, Gray J, Thomas G, Swartz J, Hsu T, Moline ML |title=Donepezil in Parkinson's disease dementia: a randomized, double-blind efficacy and safety study |journal=Mov. Disord. |volume=27 |issue=10 |pages=1230–8 |date=September 2012 |pmid=22915447 |doi=10.1002/mds.25098 |url=}}</ref> | * Dementia: [[Cholinesterase inhibitors]] such as [[rivastigmine]] and [[donepezil]] are the main treatment of [[dementia]] in [[Parkinson's disease|PD]].<ref name="pmid22419314">{{cite journal |vauthors=Rolinski M, Fox C, Maidment I, McShane R |title=Cholinesterase inhibitors for dementia with Lewy bodies, Parkinson's disease dementia and cognitive impairment in Parkinson's disease |journal=Cochrane Database Syst Rev |volume= |issue=3 |pages=CD006504 |date=March 2012 |pmid=22419314 |doi=10.1002/14651858.CD006504.pub2 |url=}}</ref><ref name="pmid15590953">{{cite journal |vauthors=Emre M, Aarsland D, Albanese A, Byrne EJ, Deuschl G, De Deyn PP, Durif F, Kulisevsky J, van Laar T, Lees A, Poewe W, Robillard A, Rosa MM, Wolters E, Quarg P, Tekin S, Lane R |title=Rivastigmine for dementia associated with Parkinson's disease |journal=N. Engl. J. Med. |volume=351 |issue=24 |pages=2509–18 |date=December 2004 |pmid=15590953 |doi=10.1056/NEJMoa041470 |url=}}</ref><ref name="pmid22915447">{{cite journal |vauthors=Dubois B, Tolosa E, Katzenschlager R, Emre M, Lees AJ, Schumann G, Pourcher E, Gray J, Thomas G, Swartz J, Hsu T, Moline ML |title=Donepezil in Parkinson's disease dementia: a randomized, double-blind efficacy and safety study |journal=Mov. Disord. |volume=27 |issue=10 |pages=1230–8 |date=September 2012 |pmid=22915447 |doi=10.1002/mds.25098 |url=}}</ref> | ||
* Fatigue: [[Amantadine]], [[methylphenidate]] and [[pemoline]] can improve [[fatigue]] in [[Parkinson's disease|PD]] patients.<ref name="pmid26447539">{{cite journal |vauthors=Elbers RG, Verhoef J, van Wegen EE, Berendse HW, Kwakkel G |title=Interventions for fatigue in Parkinson's disease |journal=Cochrane Database Syst Rev |volume= |issue=10 |pages=CD010925 |date=October 2015 |pmid=26447539 |doi=10.1002/14651858.CD010925.pub2 |url=}}</ref><ref name="pmid17674415">{{cite journal |vauthors=Mendonça DA, Menezes K, Jog MS |title=Methylphenidate improves fatigue scores in Parkinson disease: a randomized controlled trial |journal=Mov. Disord. |volume=22 |issue=14 |pages=2070–6 |date=October 2007 |pmid=17674415 |doi=10.1002/mds.21656 |url=}}</ref><ref name="pmid20231670">{{cite journal |vauthors=Zesiewicz TA, Sullivan KL, Arnulf I, Chaudhuri KR, Morgan JC, Gronseth GS, Miyasaki J, Iverson DJ, Weiner WJ |title=Practice Parameter: treatment of nonmotor symptoms of Parkinson disease: report of the Quality Standards Subcommittee of the American Academy of Neurology |journal=Neurology |volume=74 |issue=11 |pages=924–31 |date=March 2010 |pmid=20231670 |doi=10.1212/WNL.0b013e3181d55f24 |url=}}</ref> | * Fatigue: [[Amantadine]], [[methylphenidate]] and [[pemoline]] can improve [[fatigue]] in [[Parkinson's disease|PD]] patients.<ref name="pmid26447539">{{cite journal |vauthors=Elbers RG, Verhoef J, van Wegen EE, Berendse HW, Kwakkel G |title=Interventions for fatigue in Parkinson's disease |journal=Cochrane Database Syst Rev |volume= |issue=10 |pages=CD010925 |date=October 2015 |pmid=26447539 |doi=10.1002/14651858.CD010925.pub2 |url=}}</ref><ref name="pmid17674415">{{cite journal |vauthors=Mendonça DA, Menezes K, Jog MS |title=Methylphenidate improves fatigue scores in Parkinson disease: a randomized controlled trial |journal=Mov. Disord. |volume=22 |issue=14 |pages=2070–6 |date=October 2007 |pmid=17674415 |doi=10.1002/mds.21656 |url=}}</ref><ref name="pmid20231670">{{cite journal |vauthors=Zesiewicz TA, Sullivan KL, Arnulf I, Chaudhuri KR, Morgan JC, Gronseth GS, Miyasaki J, Iverson DJ, Weiner WJ |title=Practice Parameter: treatment of nonmotor symptoms of Parkinson disease: report of the Quality Standards Subcommittee of the American Academy of Neurology |journal=Neurology |volume=74 |issue=11 |pages=924–31 |date=March 2010 |pmid=20231670 |doi=10.1212/WNL.0b013e3181d55f24 |url=}}</ref> |
Revision as of 03:51, 28 November 2018
Parkinson's disease Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The mainstay of therapy for motor symptoms of Parkinson disease are:
- Levodopa
- Dopamine agonists
- Monoamine oxidase (MAO) B inhibitors
- Anticholinergic agents
- Amantadine: Amantadine
- Catechol-O-methyl transferase (COMT) inhibitors
- Estrogen
- Other drugs such as Exenatide[1], uric acid[2], isradipine[3], nilotinib[4] and GDNF infusion[5]
Treatment choices for some of the nonmotor symptoms of PD are:
- Psychosis: Drugs such as quetiapine, clozapine and pimavanserin are used in managing psychosis in PD.[6][7] one of the side effects of clozapine is leukopenia and agranulocytosis.[8]
- Dementia: Cholinesterase inhibitors such as rivastigmine and donepezil are the main treatment of dementia in PD.[9][10][11]
- Fatigue: Amantadine, methylphenidate and pemoline can improve fatigue in PD patients.[12][13][14]
- Depression: Amitriptyline[15], desipramine, citalopram[16],paroxetine, venlafaxine[17], ropinirole and pramipexole[18][19][20] are useful in managing depression in PD patients. If we intent to use tricyclics we should be aware that their anticholinergic effect can increase orthostatic hypotension and cognitive impairment[21] and for SSRI we should know that they can cause dystonia, tremor and parkinsonism.[22] the combination of MAO B inhibitors with SSRIs or tricyclics can cause serotonin syndromes[23]
- Constipation: Increasing probiotics and fibers, lubiprostone and polyethylene glycol are effective in treatment of constipation.[24][25][26]
- Sialorrhea: If the sialorrhea is mild we can treat it with chewing gum and hard candy[27][28] but in severe cases, botulinum toxin injection into salivary glands is helpful.[18][29]
- Sexual dysfunction: Male sexual dysfunction can be treated with sildenafil.[30]
- Ortostatic hypotention: Fludrocortisone[31], Sympathomimetic agents such as ephedrine, pseudoephedrine, methylphenidate and dextroamphetamine are used to treat orthostatic hypotension.[32][33]
Medical Therapy
The mainstay of therapy for motor symptoms of Parkinson disease are:
- Levodopa: This drug is the most effective in controlling motor symptoms in PD patients.[34][35] If we use levodopa alone, it will convert to dopamine in the peripheral circulation, so we combine it with a decarboxylase inhibitor like carbidopa to prevent this. The ratio of carbidopa_levodopa in tablets are 10/100, 25/100 or 25/250.[36][37] The adverse effects of this drug includes elevated serum homocysteine, low levels of vitamin B12, elevated methylmalonic acid and sensorimotor peripheral neuropathy.[38][39][40][41] It can also cause motor fluctuations, dyskinesia, cramps and dystonia.[42][43] One of the concerns regarding long term use of levodopa is that it may be increase the rate of dopamine neurons degeneration[44] but other studies demonstrated that it does not damage neurons.[45][46]
- Dopamine agonists: Dopamine agonist such as bromocriptine, pramipexole and ropinirole are proved to be effective in managing motor symptoms of PD patients.[47] At first, the use of dopamine agonist were limited t the condition where there is reduced levodopa response or when we had disturbing levodopa complications[48][49] but since dopamine agonists have fewer side effects, some experts suggest using these drugs as the first line therapy especially for PD patients under 60 years old.[50] The adverse effects of dopamine agonist are nausea, vomiting, sleep disorders, confusion, peripheral edema and valvular heart disease.[51][52]
- Monoamine oxidase (MAO) B inhibitors: MAO B inhibitors such as selegiline, rasagiline and safinamide are proved to be helpful in managing motor symptoms of PD patients.[53][54][55][56] these drugs can cause nausea and headaches.[54] Rasagiline can also cause impulse control disorders.[57]
- Anticholinergic agents: In PD we have reduced amount of dopamine and excess amount of cholinergic effects, so anticholinergic drugs such as trihexyphenidyl and benztropine can reduce the symptoms of PD.[58][59][60]
- Amantadine: Amantadine, an antiviral drug can improve PD symptoms by increasing dopamine release, inhibition of dopamine reuptake, stimulation of dopamine receptors and anticholinergic effect.[61][62] Some studies showed that in controlling bardykinesia, this drug can be more effective than anticholinergic drugs.[63]
- Catechol-O-methyl transferase (COMT) inhibitors: The catechol-o-methyl transferase (COMT) inhibitors such as entacapone and tolcapone can potentiate the effect of levodopa in reducing PD motor symptoms.[64][65]
- Estrogen: In postmenopausal women who are experiencing motor fluctuation on antiparkinsonism drugs we can use low dose estrogen to improve their condition.[66][67]
- Other agents: Other drugs such as Exenatide[1], uric acid[2], isradipine[3], nilotinib[4] and GDNF infusion[5] can be effective in controlling PD patients symptoms.
Treatment choices for some of the nonmotor symptoms of PD are:
- Psychosis: Drugs such as quetiapine, clozapine and pimavanserin are used in managing psychosis in PD.[6][7] one of the side effects of clozapine is leukopenia and agranulocytosis.[8]
- Dementia: Cholinesterase inhibitors such as rivastigmine and donepezil are the main treatment of dementia in PD.[9][10][11]
- Fatigue: Amantadine, methylphenidate and pemoline can improve fatigue in PD patients.[12][13][14]
- Depression: Amitriptyline[15], desipramine, citalopram[16],paroxetine, venlafaxine[17], ropinirole and pramipexole[18][19][20] are useful in managing depression in PD patients. If we intent to use tricyclics we should be aware that their anticholinergic effect can increase orthostatic hypotension and cognitive impairment[21] and for SSRI we should know that they can cause dystonia, tremor and parkinsonism.[22] the combination of MAO B inhibitors with SSRIs or tricyclics can cause serotonin syndromes[23]
- Constipation: Increasing probiotics and fibers, lubiprostone and polyethylene glycol are effective in treatment of constipation.[24][25][26]
- Sialorrhea: If the sialorrhea is mild we can treat it with chewing gum and hard candy[27][28] but in severe cases, botulinum toxin injection into salivary glands is helpful.[18][29]
- Sexual dysfunction: Male sexual dysfunction can be treated with sildenafil.[30]
- Ortostatic hypotention: Fludrocortisone[31], Sympathomimetic agents such as ephedrine, pseudoephedrine, methylphenidate and dextroamphetamine are used to treat orthostatic hypotension.[32][33]
References
- ↑ 1.0 1.1 Harkavyi A, Abuirmeileh A, Lever R, Kingsbury AE, Biggs CS, Whitton PS (May 2008). "Glucagon-like peptide 1 receptor stimulation reverses key deficits in distinct rodent models of Parkinson's disease". J Neuroinflammation. 5: 19. doi:10.1186/1742-2094-5-19. PMC 2426681. PMID 18492290.
- ↑ 2.0 2.1 Ascherio A, LeWitt PA, Xu K, Eberly S, Watts A, Matson WR, Marras C, Kieburtz K, Rudolph A, Bogdanov MB, Schwid SR, Tennis M, Tanner CM, Beal MF, Lang AE, Oakes D, Fahn S, Shoulson I, Schwarzschild MA (December 2009). "Urate as a predictor of the rate of clinical decline in Parkinson disease". Arch. Neurol. 66 (12): 1460–8. doi:10.1001/archneurol.2009.247. PMC 2795011. PMID 19822770.
- ↑ 3.0 3.1 Ilijic E, Guzman JN, Surmeier DJ (August 2011). "The L-type channel antagonist isradipine is neuroprotective in a mouse model of Parkinson's disease". Neurobiol. Dis. 43 (2): 364–71. doi:10.1016/j.nbd.2011.04.007. PMC 3235730. PMID 21515375.
- ↑ 4.0 4.1 Wyse RK, Brundin P, Sherer TB (July 2016). "Nilotinib - Differentiating the Hope from the Hype". J Parkinsons Dis. 6 (3): 519–22. doi:10.3233/JPD-160904. PMC 5044778. PMID 27434298.
- ↑ 5.0 5.1 Gill SS, Patel NK, Hotton GR, O'Sullivan K, McCarter R, Bunnage M, Brooks DJ, Svendsen CN, Heywood P (May 2003). "Direct brain infusion of glial cell line-derived neurotrophic factor in Parkinson disease". Nat. Med. 9 (5): 589–95. doi:10.1038/nm850. PMID 12669033.
- ↑ 6.0 6.1 Shotbolt P, Samuel M, David A (November 2010). "Quetiapine in the treatment of psychosis in Parkinson's disease". Ther Adv Neurol Disord. 3 (6): 339–50. doi:10.1177/1756285610389656. PMC 3002640. PMID 21179595.
- ↑ 7.0 7.1 Cummings J, Isaacson S, Mills R, Williams H, Chi-Burris K, Corbett A, Dhall R, Ballard C (February 2014). "Pimavanserin for patients with Parkinson's disease psychosis: a randomised, placebo-controlled phase 3 trial". Lancet. 383 (9916): 533–40. doi:10.1016/S0140-6736(13)62106-6. PMID 24183563.
- ↑ 8.0 8.1 Schulte P (April 2006). "Risk of clozapine-associated agranulocytosis and mandatory white blood cell monitoring". Ann Pharmacother. 40 (4): 683–8. doi:10.1345/aph.1G396. PMID 16595571.
- ↑ 9.0 9.1 Rolinski M, Fox C, Maidment I, McShane R (March 2012). "Cholinesterase inhibitors for dementia with Lewy bodies, Parkinson's disease dementia and cognitive impairment in Parkinson's disease". Cochrane Database Syst Rev (3): CD006504. doi:10.1002/14651858.CD006504.pub2. PMID 22419314.
- ↑ 10.0 10.1 Emre M, Aarsland D, Albanese A, Byrne EJ, Deuschl G, De Deyn PP, Durif F, Kulisevsky J, van Laar T, Lees A, Poewe W, Robillard A, Rosa MM, Wolters E, Quarg P, Tekin S, Lane R (December 2004). "Rivastigmine for dementia associated with Parkinson's disease". N. Engl. J. Med. 351 (24): 2509–18. doi:10.1056/NEJMoa041470. PMID 15590953.
- ↑ 11.0 11.1 Dubois B, Tolosa E, Katzenschlager R, Emre M, Lees AJ, Schumann G, Pourcher E, Gray J, Thomas G, Swartz J, Hsu T, Moline ML (September 2012). "Donepezil in Parkinson's disease dementia: a randomized, double-blind efficacy and safety study". Mov. Disord. 27 (10): 1230–8. doi:10.1002/mds.25098. PMID 22915447.
- ↑ 12.0 12.1 Elbers RG, Verhoef J, van Wegen EE, Berendse HW, Kwakkel G (October 2015). "Interventions for fatigue in Parkinson's disease". Cochrane Database Syst Rev (10): CD010925. doi:10.1002/14651858.CD010925.pub2. PMID 26447539.
- ↑ 13.0 13.1 Mendonça DA, Menezes K, Jog MS (October 2007). "Methylphenidate improves fatigue scores in Parkinson disease: a randomized controlled trial". Mov. Disord. 22 (14): 2070–6. doi:10.1002/mds.21656. PMID 17674415.
- ↑ 14.0 14.1 Zesiewicz TA, Sullivan KL, Arnulf I, Chaudhuri KR, Morgan JC, Gronseth GS, Miyasaki J, Iverson DJ, Weiner WJ (March 2010). "Practice Parameter: treatment of nonmotor symptoms of Parkinson disease: report of the Quality Standards Subcommittee of the American Academy of Neurology". Neurology. 74 (11): 924–31. doi:10.1212/WNL.0b013e3181d55f24. PMID 20231670.
- ↑ 15.0 15.1 Serrano-Dueñas M (2002). "[A comparison between low doses of amitriptyline and low doses of fluoxetin used in the control of depression in patients suffering from Parkinson's disease]". Rev Neurol (in Spanish; Castilian). 35 (11): 1010–4. PMID 12497304.
- ↑ 16.0 16.1 Devos D, Dujardin K, Poirot I, Moreau C, Cottencin O, Thomas P, Destée A, Bordet R, Defebvre L (April 2008). "Comparison of desipramine and citalopram treatments for depression in Parkinson's disease: a double-blind, randomized, placebo-controlled study". Mov. Disord. 23 (6): 850–7. doi:10.1002/mds.21966. PMID 18311826.
- ↑ 17.0 17.1 Richard IH, McDermott MP, Kurlan R, Lyness JM, Como PG, Pearson N, Factor SA, Juncos J, Serrano Ramos C, Brodsky M, Manning C, Marsh L, Shulman L, Fernandez HH, Black KJ, Panisset M, Christine CW, Jiang W, Singer C, Horn S, Pfeiffer R, Rottenberg D, Slevin J, Elmer L, Press D, Hyson HC, McDonald W (April 2012). "A randomized, double-blind, placebo-controlled trial of antidepressants in Parkinson disease". Neurology. 78 (16): 1229–36. doi:10.1212/WNL.0b013e3182516244. PMC 3324323. PMID 22496199.
- ↑ 18.0 18.1 18.2 18.3 Seppi K, Weintraub D, Coelho M, Perez-Lloret S, Fox SH, Katzenschlager R, Hametner EM, Poewe W, Rascol O, Goetz CG, Sampaio C (October 2011). "The Movement Disorder Society Evidence-Based Medicine Review Update: Treatments for the non-motor symptoms of Parkinson's disease". Mov. Disord. 26 Suppl 3: S42–80. doi:10.1002/mds.23884. PMC 4020145. PMID 22021174.
- ↑ 19.0 19.1 Pahwa R, Stacy MA, Factor SA, Lyons KE, Stocchi F, Hersh BP, Elmer LW, Truong DD, Earl NL (April 2007). "Ropinirole 24-hour prolonged release: randomized, controlled study in advanced Parkinson disease". Neurology. 68 (14): 1108–15. doi:10.1212/01.wnl.0000258660.74391.c1. PMID 17404192.
- ↑ 20.0 20.1 Barone P, Poewe W, Albrecht S, Debieuvre C, Massey D, Rascol O, Tolosa E, Weintraub D (June 2010). "Pramipexole for the treatment of depressive symptoms in patients with Parkinson's disease: a randomised, double-blind, placebo-controlled trial". Lancet Neurol. 9 (6): 573–80. doi:10.1016/S1474-4422(10)70106-X. PMID 20452823.
- ↑ 21.0 21.1 Miyasaki JM, Shannon K, Voon V, Ravina B, Kleiner-Fisman G, Anderson K, Shulman LM, Gronseth G, Weiner WJ (April 2006). "Practice Parameter: evaluation and treatment of depression, psychosis, and dementia in Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology". Neurology. 66 (7): 996–1002. doi:10.1212/01.wnl.0000215428.46057.3d. PMID 16606910.
- ↑ 22.0 22.1 Bharucha KJ, Sethi KD (May 1996). "Complex movement disorders induced by fluoxetine". Mov. Disord. 11 (3): 324–6. doi:10.1002/mds.870110318. PMID 8723152.
- ↑ 23.0 23.1 Richard IH, Kurlan R, Tanner C, Factor S, Hubble J, Suchowersky O, Waters C (April 1997). "Serotonin syndrome and the combined use of deprenyl and an antidepressant in Parkinson's disease. Parkinson Study Group". Neurology. 48 (4): 1070–7. PMID 9109902.
- ↑ 24.0 24.1 Ondo WG, Kenney C, Sullivan K, Davidson A, Hunter C, Jahan I, McCombs A, Miller A, Zesiewicz TA (May 2012). "Placebo-controlled trial of lubiprostone for constipation associated with Parkinson disease". Neurology. 78 (21): 1650–4. doi:10.1212/WNL.0b013e3182574f28. PMID 22573627.
- ↑ 25.0 25.1 Zangaglia R, Martignoni E, Glorioso M, Ossola M, Riboldazzi G, Calandrella D, Brunetti G, Pacchetti C (July 2007). "Macrogol for the treatment of constipation in Parkinson's disease. A randomized placebo-controlled study". Mov. Disord. 22 (9): 1239–44. doi:10.1002/mds.21243. PMID 17566120.
- ↑ 26.0 26.1 Barichella M, Pacchetti C, Bolliri C, Cassani E, Iorio L, Pusani C, Pinelli G, Privitera G, Cesari I, Faierman SA, Caccialanza R, Pezzoli G, Cereda E (September 2016). "Probiotics and prebiotic fiber for constipation associated with Parkinson disease: An RCT". Neurology. 87 (12): 1274–80. doi:10.1212/WNL.0000000000003127. PMID 27543643.
- ↑ 27.0 27.1 Pfeiffer RF (January 2011). "Gastrointestinal dysfunction in Parkinson's disease". Parkinsonism Relat. Disord. 17 (1): 10–5. doi:10.1016/j.parkreldis.2010.08.003. PMID 20829091.
- ↑ 28.0 28.1 Cloud LJ, Greene JG (August 2011). "Gastrointestinal features of Parkinson's disease". Curr Neurol Neurosci Rep. 11 (4): 379–84. doi:10.1007/s11910-011-0204-0. PMID 21499704.
- ↑ 29.0 29.1 Chinnapongse R, Gullo K, Nemeth P, Zhang Y, Griggs L (February 2012). "Safety and efficacy of botulinum toxin type B for treatment of sialorrhea in Parkinson's disease: a prospective double-blind trial". Mov. Disord. 27 (2): 219–26. doi:10.1002/mds.23929. PMID 21887710.
- ↑ 30.0 30.1 Raffaele R, Vecchio I, Giammusso B, Morgia G, Brunetto MB, Rampello L (April 2002). "Efficacy and safety of fixed-dose oral sildenafil in the treatment of sexual dysfunction in depressed patients with idiopathic Parkinson's disease". Eur. Urol. 41 (4): 382–6. PMID 12074807.
- ↑ 31.0 31.1 Campbell IW, Ewing DJ, Clarke BF (April 1975). "9-Alpha-fluorohydrocortisone in the treatment of postural hypotension in diabetic autonomic neuropathy". Diabetes. 24 (4): 381–4. PMID 1094320.
- ↑ 32.0 32.1 Davies B, Bannister R, Sever P (January 1978). "Pressor amines and monoamine-oxidase inhibitors for treatment of postural hypotension in autonomic failure. Limitations and hazards". Lancet. 1 (8057): 172–5. PMID 74603.
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