Abstract

VARGAS JARAMILLO, Juan Diego  and  BARRIOS VINCOS, Gustavo. Treatment of early Parkinson's disease. Acta Neurol Colomb. [online]. 2019, vol.35, suppl.1, pp.11-18. ISSN 0120-8748.  https://doi.org/10.22379/24224022245.

Parkinson's disease (PD) is primarily a disease of elderly patients. Is a multifaceted disorder comprised of both motor and non-motor symptoms at all stages of the disease. This review seeks to integrate data from the newest treatment options with data from established therapies, so as to provide an up-to- date evidence-based reference for clinicians treating early PD, with medications that can be used as an alternative to levodopa. The clinicians' approach to the treatment of early Parkinson's disease (PD) should take into account numerous aspects, including how to inform a patient upon diagnosis and the critical decision of what therapy to adopt and when to start it. The treatment of the motor disorder associated with early PD needs to consider several crucial factors, such as age at onset, comorbidities, and the patient's functional requirements, and cannot be summarized in a simple formula. In younger patients (i.e., before the age of 70) and in those without high functional requirements, treatment is usually initiated with dopamine agonists and/or monoamine oxidase-B enzyme inhibitors (MAO-B I). In younger patients, levodopa should be added to dopamine agonists and/or MAO-B I, as required by disease progression, whereas in older patients, when response to levodopa alone is not satisfactory, dopamine agonists or catechol-O- methyltransferase inhibitors may subsequently be added.

Keywords : Parkinson's disease; evidence-based medicine; levodopa; dopamine agonists; monoamine oxidase inhibitors; catechol-O-methyl transferase inhibitors; amantadine; anticholinergics; exercise; physical therapy; speech therapy; occupational therapy (MeSH)..

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