علاج التقلبات الحركية في مرض باركنسون

References

DOI: 10.1186/s42466-024-00325-4

Various medication options are available for treating fluctuations, including adjusting Levodopa intervals and dosages, additional administration of Levodopa preparations with modified galenic forms (soluble, inhaled, retarded), or adding dopamine agonists, MAO-B inhibitors, or COMT inhibitors.

Opicapone and Entacapone are largely equivalent in effect as COMT inhibitors and can be used for treating Levodopa-response fluctuations in PD, considering specific indications outlined below.

Tolcapone should be used cautiously due to potential hepatotoxicity, primarily as a second-line treatment with rigorous clinical and laboratory safety monitoring.

Safinamide, a dual-action MAO-B inhibitor, is not approved as monotherapy but can be used in combination with Levodopa for treating PD with fluctuations.