The Role of Dopamine Replacement on the Behavioural Phenotype of Parkinson’s Disease
نویسندگان
چکیده
OBJECTIVES The pharmacotherapy of Parkinson's disease (PD) is often challenging as clinicians have to find a favourable balance between the efficacy on motor symptoms and side effect profiles of different dopaminergic medications. We aimed to assess the available evidence on the role of dopamine agonist monotherapy as an alternative to Levodopa in the treatment of motor symptoms of PD, along with the role of dopamine antagonists in the treatment of PD-related psychosis. METHODS We performed a systematic literature review using the databases MEDLINE, EMBASE, PsycINFO and the Cochrane Library Central register of controlled trials. Two searches were performed, 'Search 1' extracting trials on dopamine agonists, and 'Search 2' on atypical antipsychotics. Eligible studies were Double-blind Randomised Controlled Trials (RCTs) using the Unified Parkinson's Disease Rating Scale (UPDRS) and the Brief Psychiatric Rating Scale (BPRS) as outcome measures for Search 1 and 2, respectively. RESULTS 16 relevant RCTs were extracted from the search results. Overall, dopamine agonists were shown to significantly improve UPDRS scores, with a mean percentage improvement of 14.4% compared to -1.9% in the control arm (P value < 0.05). However, their side effect profile illustrated they were associated with twice the incidence of psychotic symptoms in comparison to the controls. The results on the efficacy of atypical antipsychotics for the treatment of PD-related psychosis were not significant. CONCLUSIONS This evidence-based review confirmed that dopamine agonists can be an effective and safe treatment as monotherapy in PD, however psychotic symptoms remain a significant side effect. Atypical antipsychotics may not be relied upon for the correction of these symptoms due to inconsistent results about their efficacy.
منابع مشابه
Dopamine-Synthesizing Neurons: An Overview of Their Development and Application for Cell Therapy
Cell-gene therapy is a dynamic constituent of novel medical biotechnology. Neurodegenerative disordersin which damage to or demise of specific brain cell types plays central role, are clear examples of diseasecandidate for cell replacement therapy. Dopaminergic (DAergic) neurons biosynthesize dopamine, a vitalneurotransmitter in the central nervous system. Due to the involveme...
متن کاملNeuroprotective effects of endurance training in 6-hydroxydopamine rat model of Parkinson’s disease
Introduction: Parkinson’s disease (PD) is characterized by progressive dopamine depletion in the striatum, and leads to mitochondrial and motor disorders. The present study investigated the effect of moderate endurance training on motor disorder and mRNA expression of PPAR-γ, PGC-1α and BDNF in 6-hydroxydopamine (6-OHDA) rat model of PD Materials and Methods: Thirty two male Wistar rats were di...
متن کاملP139: Role of Dopamine Receptor D3 in Depression and Anxiety
Dopamine (DA) is one of the main catecholamines in the brain and is crucial for movement coordination, endocrine function, reward, mood, memory and emotions. The dopaminergic system is the primary therapeutic target in the treatment of Parkinson’s disease (PD), drug addiction and schizophrenia. Notwithstanding, dysfunction of central dopaminergic neurotransmission has also been associated to de...
متن کاملCinnamaldehyde attenuates dopaminergic neuronal loss in substantia nigra and induces midbrain catalase activity in a mouse model of Parkinson’s disease
Background and Objective: Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease that affects 3% of the population. PD involves a progressive degeneration of dopaminergic neurons in the substantia nigra pars compacta (SNc) and subsequent loss of dopamine. Dopamine depletion leads to movement dysfunction and is accompanied with tremor, rigid muscle...
متن کاملHedonistic homeostatic dysregulation in patients with Parkinson’s disease on dopamine replacement therapies
Hedonistic homeostatic dysregulation is a neuropsychological behavioural disorder associated with substance misuse and addiction. The disorder has been recognised as a consequence of dopamine replacement therapy (DRT) in 15 patients with Parkinson’s disease. The syndrome typically develops in male patients with early onset Parkinson’s disease, and can occur with orally and subcutaneously admini...
متن کامل