Parkinson Disease: Treatment

Parkinson disease (PD) is a chronic neurodegenerative disorder affecting more than 4 million people worldwide. It is expected that this number will potentially double by 2030 due to the aging population, thus transforming PD into an even bigger worldwide health concern. As PD knowledge has expanded over the past three decades, it is now recognized that multiple brain neurotransmitters and circuits are altered and collectively contribute to a constellation of motor and nonmotor symptoms. The classic symptoms required for the clinical diagnosis of PD are bradykinesia, resting tremor, rigidity, and/or loss of postural reflexes. Due to the multiple brain circuits affected as the disease advances, the nonmotor manifestations become equally, or even potentially, more troublesome for patients and caregivers. This review covers general considerations and aspects of treatment of PD. Figures show expected phases of PD, how to start therapy, and the approach to levodopa-induced complications. Tables list suggested dosages of available medications for the treatment of motor symptoms in PD, classification of levodopa-induced complications, suggested dosages of available medications for the trea