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Contemporary approaches to the pharmacotherapeutic management of Parkinson's disease

An overview

From the Parkinson's Disease and Movement Disorders Center, University of Pennsylvania Health System, Philadelphia, PA.

Address correspondence and reprint requests to Dr. Matthew B. Stern, Department of Neurology, The Graduate Hospital, 1 Graduate Plaza, Suite 900, Philadelphia, PA 19146.

Abstract.

A number of unresolved issues complicate the effective management of patients with Parkinson's disease (PD). Chief among these is the role of neuroprotective versus symptomatic pharmacologic interventions. Until the etiology of PD is further defined, consensus on appropriate management of this illness is unlikely. Clinicians may best serve their patients by taking a pragmatic approach to the treatment of PD that utilizes potentially beneficial interventions in eligible patients. Such an approach would incorporate possible neuroprotective (e.g., selegiline, dopamine agonists, sustained-release levodopa) and dopamine-sparing (e.g., combination levodopa/dopamine agonist therapy) strategies whenever possible while retaining adequate symptomatic control.

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