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Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)

Workshop IV: drug treatment guidelines for the long-term management of Parkinson's disease.

An attempt was made to establish a decision algorithm for the treatment of idiopathic Parkinson's disease at various stages and in different subgroups such as akinetic-rigid or tremor dominance type. We suggest treating young patients with selegiline and a dopamine agonist. In the tremor dominance type we use either budipine or a dopamine agonist. Due to levodopa-induced dyskinesia, we try to avoid levodopa in the early stages of the disease and use it only later in more advanced situations in a combination therapy with dopamine agonists. Since IPS is not only based upon dopamine deficiency but also on resulting glutamatergic overstimulation, we advocate the use of a glutamate antagonist such as amantadine or budipine. Catechol-O-methyl inhibitors are very helpful when wearing-off occurs. Anticholinergics are only used in the early stages of tremor-dominant IPS because we fear enhancing the risk of dementia.[1]


  1. Workshop IV: drug treatment guidelines for the long-term management of Parkinson's disease. Reichmann, H., Sommer, U., Fuchs, G., Hefter, H., Mark, G., Müller, T., Thümler, R., Ulm, G., Vieregge, P. J. Neurol. (2000) [Pubmed]
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