Nonmotor Effects of Conventional and Transdermal Dopaminergic Therapies in Parkinson's Disease

Int Rev Neurobiol. 2017:134:989-1018. doi: 10.1016/bs.irn.2017.05.008. Epub 2017 Jun 12.

Abstract

Nonmotor symptoms (NMS) are an integral component of Parkinson's disease (PD). Because the burden and range of NMS are key determinants of quality of life for patients and caregivers, their management is a crucial issue in clinical practice. Although a range of NMS have a dopaminergic pathophysiological basis, this fact is underrecognized, and thus, they are often regarded as dopamine unresponsive symptoms. However, substantial evidence indicates that many NMS respond to oral and transdermal dopaminergic therapies. In contrast, certain NMS are exacerbated or even precipitated by dopaminergic drugs and these unwanted effects may be seriously dangerous. Therefore, a dopaminergic strategy for NMS should be based on a consideration of the benefits vs the risks in individual patients with PD.

Keywords: Dopamine agonist; Dopaminergic; Levodopa; Nonmotor; Parkinson disease.

Publication types

  • Review

MeSH terms

  • Administration, Cutaneous
  • Administration, Oral
  • Autonomic Nervous System Diseases / drug therapy
  • Autonomic Nervous System Diseases / physiopathology
  • Dopamine Agents / administration & dosage*
  • Dopamine Agents / adverse effects*
  • Gastrointestinal Diseases / drug therapy
  • Gastrointestinal Diseases / epidemiology
  • Gastrointestinal Diseases / physiopathology
  • Humans
  • Mental Disorders / drug therapy
  • Mental Disorders / epidemiology
  • Mental Disorders / physiopathology
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / epidemiology*
  • Parkinson Disease / physiopathology
  • Sensation Disorders / drug therapy
  • Sensation Disorders / epidemiology
  • Sensation Disorders / physiopathology
  • Sleep Wake Disorders / drug therapy
  • Sleep Wake Disorders / epidemiology
  • Sleep Wake Disorders / physiopathology

Substances

  • Dopamine Agents