早期Parkinson病の薬物療法のポイント

抄録

To date, no anti–Parkinsonian drug has been proven to have disease–modifying effects, but Japanese guideline suggests that treatment should be initiated as early as possible after diagnosis unless there is a specific reason not to. Treatment should be initiated with L–dopa, dopamine agonists, or MAO–B inhibitors. The choice of initial treatment should be based on efficacy, short–term side effects, and avoidance of future motor complications. Currently, many types of dopamine agonists and MAO–B inhibitors are available, and it is possible that the choice of treatment may take into account their effects on non–motor symptoms. The author believes that the algorithm for early–stage Parkinson disease in the guideline is only an indication of what should be the mainstay of early treatment, and that combination treatment that utilizes the characteristics of each drug is important rather than relying on one drug.