Understanding Parkinson's Disease

Pharmacological treatment options for Parkinson's disease

Pharmacological treatment options:

Dopaminergic agents1

  • Levodopa
    • Levodopa + benserazide
    • Levodopa + carbidopa
  • COMT inhibitors* (entacapone, tolcapone) [administered with levodopa in a fixed or flexible combination]
  • Dopamine agonist
    • Non-ergot**
      • Piribedil
      • Pramipexole
      • Ropinirole
      • Rotigotine
    • Ergot
      • Bromocriptine
      • Cabergoline
      • Dihydroergocryptine
      • Lisuride
      • Pergolide
      • Selective MAO-B*** inhibitors
    • Rasagiline
    • Selegiline

Non-dopaminergic agents1

  • Anticholinergic agents:
    • Benztropine
    • Trihexyphenidyl
  • NMDA**** antagonists
    • Amantadine
* catechol-O-methyltransferase inhibitors; always used in conjunction with levodopa
** apomorphine is available for subcutaneous injections and may be useful in patients with levodopa-related motor fluctuations
*** monoamine oxidase type-B
**** N-methyl-D-aspartate

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  1. Adapted from Schapira AHV et al. Treatment options in the modern management of Parkinson disease. Archives of Neurology 2007; 64(8): 1083-1088.

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