Article

In this article, we discuss the management of motor symptoms during the early
phases of Parkinson's disease, excluding that of any other clinical
manifestation. We relied primarily upon recently published data and do not
describe older publications relating to anticholinergic drugs or amantadine. The
initial pharmacological treatment of idiopathic Parkinson's disease (IPD) is
symptomatic and remains based upon dopaminergic drugs. However, the development
of new drugs has broadened the range of strategic options and improved overall
patient management. Announcing the diagnosis is a critical moment, as pointed out
by patients' associations. Patients should be advised to maintain personal,
professional, social and physical activities as long as possible. The potential
benefit of early pharmacological treatment should be explained, focusing on the
possible disease-modifying effect of drugs such as rasagiline. According to
current guidelines, L-Dopa is preferred in patients above 65years of age, while
those below 65 should be treated with dopamine agonists. Like monoamine oxidase
inhibitors B (MAOI-B), synthetic dopamine agonists exhibit several advantages:
easy-to-use treatment with a once-daily administration, delayed L-Dopa
initiation, significant efficacy on motor symptoms (although lower than that of
L-Dopa). MOAI can be prescribed in association with L-Dopa or dopamine agonists.
Rasagiline also delays L-Dopa initiation, and consequently motor complications.
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Langue : FRANCAIS