Antiparkinsonian Drugs

The Parkinson's-Reversing Breakthrough

Treatment for Parkinson Disease

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Parkinson's disease is a degenerative, slowly progressing illness of the CNS characterized by bradykinesia, shuffling gait, postural instability, tremor, and loss of automatic movement, which is associated with damaged basal ganglions. The etiology of this illness is not known. The most likely cause of the aforementioned motor problems could be a lack of dopamine, which has an inhibitory effect on the regulatory function of the spinal cord. On the other hand, cholinergic neurons act in regulating the extrapyramidal system. For more than a century, treatment of Parkinsonism was based on use of central anticholinergic substances. Up until recent times, various alkaloid drugs of belladonna, which have a characteristic cholinergic action (i.e. the ability to reduce sensitivity to acetylcholine, a neurotransmitter of cholinergic synapses) have been used for Parkinsonism. Currently, a sufficient quantity of facts have been established that support the idea that Parkinsonism is a consequence of an imbalance between dopaminergic and cholinergic systems, and that treatment of Parkinsonism should consist of either blocking excessive stimulation of the cholinergic system, or normalizing functional activity of the dopaminergic system. Consequently, one of the approaches of Parkinsonism pharmacotherapy may include eliminating the deficit of dopamine. Because dopamine itself does not penetrate through the blood-brain barrier, either a dopamine precursor (levodopa), drugs that release dopamine, dopamine receptor agonists, or inactivation inhibitors of dopamine are used. On the other hand, during treatment of Parkinsonism, anticholinergic drugs should be used. From the information cited above, treatment of Parkinsonism should be based on using two groups of substances: drugs which stimulate the dopaminergic system of the brain and substances which inhibit the cholinergic system of the brain.

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