2018 Volume 35 Issue 3 Pages 251-253
Parkinson's disease is a neurodegenerative disease showing movement disorders and variable systemic non–motor symptoms. Motor symptoms are manifested by magnification of Lewy pathology into the substantia nigra pars compacta, which induces dopaminergic neuronal loss and dopamine deficiency in the nigro–striatal dopaminergic projection. The activity of daily life and/or social activity can be directly obstructed by the motor deficits. Levodopa replacement therapy is the gold standard in pharmacotherapy in Parkinson's disease. Now a days, dopaminergic agonists, dopamine economizers as well as non–dopaminergic agents are clinically available in Japan. Drug delivery systems are also developed as transdermal and intrajejunal administration in Japan, subcutaneous continuous injection and sublingual film in foreign countries. Most of them are based on the therapeutical strategy of the concept of continuous dopaminergic stimulation. Non–motor symptoms are alternative practical problems in Parkinson's disease, which include sensory problems, autonomic dysfunctions, mood disorders, cognitive dysfunction, and so on. Because non–motor symptoms are variable and uneasy to cure, a medical treatment corresponding to each non–motor problem are required in clinical practice. These can deteriorate patients' quality of life as unmet needs. Practical pharmacotherapy is important against these refractory problems, which should be established on the well–organized communication between physicians and both patients and care givers as well as an advanced adherence.
