Applications of new drug delivery technologies to Parkinson's disease and dopaminergic agents.

Recent advances in drug delivery technology are creating novel therapeutic approaches to the treatment of Parkinson's disease with levodopa and dopamine agonists. This article reviews those technologies which can be applied to Parkinson's disease, both for targetting the central nervous system with drugs, as well as for matching the appropriate rate controlled delivery with therapeutic needs. In particular, the possibility exists for eliminating erratic highs and lows of drug delivery to the brain, and to substitute rate controlled, constant drug delivery. Clinical investigations now in progress suggest that new technologies which deliver constant dopaminergic stimulation to patients with Parkinson's disease may not only eliminate the unpredictable swings in therapeutic efficacy in Parkinson patients with the "on/off" effect, but may even have a role in the future in preventing such fluctuations from developing in patients chronically treated with dopaminergic therapies.