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Polypharmacy in Parkinson’s disease: risks and benefits with little evidence

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

Polypharmacy is common practice in Parkinson’s disease. Medical treatment targeting the dopaminergic system alone may include up to five different compounds: l-DOPA (in combination with a DOPA decarboxylase inhibitor), a catechol-O-methyltransferase (COMT) and a monoamine oxidase (MAO-B) inhibitor and a dopamine agonist. Particular motor and non-motor symptoms may require additional specific therapeutics, such as drugs aimed at tremor control and to treat depression, dementia and orthostatic and autonomic dysfunction. No prospective studies have yet been performed with regard to the efficacy or the long-term benefit of combining such different treatments in Parkinson’s disease and retrospective analyses are sparse. We thus tried to compile the available evidence for polypharmacy strategies in Parkinson’s disease and devised an expert opinion statement.

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Authors and Affiliations

  1. Gertrudis Clinic Parkinson-Center, Biskirchen, Germany

    I. Csoti

  2. Neurozentrum Stuttgart, Sophienstraße 41, 70178, Stuttgart, Germany

    H. Herbst

  3. Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Germany

    P. Urban

  4. Katholische Kliniken Ruhrhalbinsel gGmbH, Heidbergweg 22-24, 45257, Essen, Germany

    D. Woitalla

  5. Department of Neurology, University of Bonn, Bonn, Germany

    U. Wüllner

  6. German Centre for Neurodegenerative Disease Research (DZNE), Bonn, Germany

    U. Wüllner

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  1. I. Csoti
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  2. H. Herbst
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  3. P. Urban
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  5. U. Wüllner
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Correspondence to U. Wüllner.

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Csoti, I., Herbst, H., Urban, P. et al. Polypharmacy in Parkinson’s disease: risks and benefits with little evidence. J Neural Transm 126, 871–878 (2019). https://doi.org/10.1007/s00702-019-02026-8

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  • DOI: https://doi.org/10.1007/s00702-019-02026-8

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