Summary
In the light of present day knowledge, augmenting striatal dopaminergic activity is the most effective means for controlling the symptoms of parkinsonism. This is best accomplished by the administration of levodopa with a peripheral decarboxylase inhibitor. However, limitations in its benefits develop after long-term administration in a substantial number of patients. In an attempt to overcome these a number of pharmacological agents acting on striatal dopaminergic mechanisms have undergone clinical trial. Of those tried Deprenyl, an MAO-B inhibitor, given with levodopa and carbidopa has shown the most promise. Preliminary results in 35 patients indicate that it is useful in diminishing the incidence of “on-off” phenomena—one of the most limiting reactions to levodopa—as well as enabling some patients to recoup their loss of therapeutic benefits. Though far from resolving all of the therapeutic difficulties encountered with prolonged use of levodopa, it appears to be a valuable adjunctive agent for the long-term problem patient.
Similar content being viewed by others
References
Yahr, M. D. Evaluation of long-term therapy in Parkinson's disease: Mortality and therapeutic efficacy. In: Advances in Parkinsonism (Blrkmayer, W., Hornykiewicz, O., eds.), pp. 435–443. Basle: Editiones Roche. 1976.
Marsden, C. D., Parkes, J. D. Lanceti, 345 (1977).
Lloyd, K. G., Davidson, L., Hornykiewicz, O. The neurochemistry of Parkinson's disease: Effect of L-Dopa therapy. J. Pharmacol. and Exper. Ther.195, 453–464 (1975).
Yahr, M. D. Variations in the “on-off” effect. Adv. Neurol.5, 397 to 404 (1974).
Knoll, J. Analysis of the pharmacological effects of selective monoamine oxidase inhibitors. CIBA Foundation Symposium 39 (new series), pp. 135–161. Amsterdam-Oxford-New York: Elsevier, Excerpta Medica. North-Holland. 1976.
Youdim, M. B. H., Collins, G. G. S., Sandler, M., Jones, Bevan, A. B., Pare, C. M. B., Nicholson, W. J. Human brain monoamine oxidase, multiple forms and selective inhibitors. Nature236, 225–228 (1972).
Birkmayer, W., Riederer, P., Youdim, M. B. H., Linauer, W. The potentiation of the anti-akinetic effect after L-Dopa treatment by an inhibitor of MAO-B, Deprenil. J. Neural Transm.36, 303–326 (1975).
Yahr, M. D., Duvoisin, R. C., Schear, M. J., Barrett, R. E., Hoehn, M. M. Treatment of parkinsonism with levodopa. Arch. Neurol.21, 343–354 (1969).
Lees, A. J., Kohout, L. J., Shaw, K. M., Stern, G. M., Elsworth, J. D., Sandler, M., Youdim, M. D. H. Deprenyl in Parkinson's disease. Lancetii, 791 (1977).
Author information
Authors and Affiliations
Additional information
Supported in part by the Clinical Center for Research in Parkinson's and Allied Diseases NIH Grant # NS-11631-05 and NIH Grant # RR-71 Division of Research Resources, General Research Center Branch.
Rights and permissions
About this article
Cite this article
Yahr, M.D. Overview of present day treatment of Parkinson's disease. J. Neural Transmission 43, 227–238 (1978). https://doi.org/10.1007/BF01246959
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF01246959