PURPOSE OF REVIEW: Non-motor symptoms in patients with Parkinson's Disease (PD) are better predictors of quality of life changes, caregiver burden, and mortality than motor symptoms. Levodopa has limited, and sometimes detrimental, effects on these symptoms. In this review we discuss recent evidence on pharmacological treatments for non-motor symptoms. RECENT FINDINGS: Breakthroughs have been made in the treatment of psychosis and sleep dysfunction. Pimavanserin has become the first FDA approved drug for PD psychosis. There is also new research supporting cholinesterase inhibitors for sleep disorders in PD. Other studies, including several novel treatments, have shown mixed results for apathy, depression, and fatigue. SUMMARY: Further research is needed to develop treatments for non-motor symptoms in PD. Preclinical and postmortem studies indicate that non-motor symptoms in PD may arise from pathology in non-dopamine systems. Although sometimes used off-label, therapies that target such systems have been under-utilized in treating non-motor symptoms and warrant further clinical investigation.
PURPOSE OF REVIEW: Non-motor symptoms in patients with Parkinson's Disease (PD) are better predictors of quality of life changes, caregiver burden, and mortality than motor symptoms. Levodopa has limited, and sometimes detrimental, effects on these symptoms. In this review we discuss recent evidence on pharmacological treatments for non-motor symptoms. RECENT FINDINGS: Breakthroughs have been made in the treatment of psychosis and sleep dysfunction. Pimavanserin has become the first FDA approved drug for PD psychosis. There is also new research supporting cholinesterase inhibitors for sleep disorders in PD. Other studies, including several novel treatments, have shown mixed results for apathy, depression, and fatigue. SUMMARY: Further research is needed to develop treatments for non-motor symptoms in PD. Preclinical and postmortem studies indicate that non-motor symptoms in PD may arise from pathology in non-dopamine systems. Although sometimes used off-label, therapies that target such systems have been under-utilized in treating non-motor symptoms and warrant further clinical investigation.
Authors: Lonneke M L de Lau; Dagmar Verbaan; Johan Marinus; Jacobus J van Hilten Journal: Parkinsonism Relat Disord Date: 2014-03-12 Impact factor: 4.891
Authors: A J H Moonen; A Wijers; A F G Leentjens; C W Christine; S A Factor; J Juncos; J M Lyness; L Marsh; M Panisset; R Pfeiffer; D Rottenberg; C Serrano Ramos; L Shulman; C Singer; J Slevin; W McDonald; P Auinger; I H Richard Journal: Parkinsonism Relat Disord Date: 2014-03-18 Impact factor: 4.891
Authors: Elin B Forsaa; Jan Petter Larsen; Tore Wentzel-Larsen; Christopher G Goetz; Glenn T Stebbins; Dag Aarsland; Guido Alves Journal: Arch Neurol Date: 2010-08
Authors: Ariel B Neikrug; Julie A Avanzino; Lianqi Liu; Jeanne E Maglione; Loki Natarajan; Jody Corey-Bloom; Barton W Palmer; Jose S Loredo; Sonia Ancoli-Israel Journal: Sleep Med Date: 2014-05-10 Impact factor: 3.492