Editorial Foreword: Drugs for Parkinson’s disease: Levodopa is still the gold standard || FREE PAPER ||
Authors Roger M Pinder
Published 8 February 2008 Volume 2008:4(1)
Roger M Pinder
Parkinson’s disease (PD) is a global affliction which occurs in all ethnic groups and socioeconomic classes, with estimated incidences ranging from 16–19 per 100,000 people per year and crude prevalence rates as high as 160 per 100,000 people per year (WHO/WFN 2004). It was recently estimated that there were over 1 million PD patients in Western Europe and the USA in 2005, and this number was expected to double by 2030 with accompanying dramatic rises in the numbers in developing countries (Dorsey et al 2007). Patients have both disabling motor symptoms and distressing non-motor features like depression and anxiety. Pharmacotherapy for PD has been available since the 1950s in the form of anticholinergic drugs, which are of limited efficacy and carry a high burden of gastrointestinal and neuropsychiatric side effects (Katzenschlager 2007). More effective treatment arrived in the early 1960s with the first clinical trials of levodopa (Birkmayer and Horneykiewicz 1961), and there are now many different formulations and variants on the levodopa theme (Lundqvist 2007) as well as a plethora of selective dopamine agonists of the ergoline and nonergoline type (Pinder 2007). The only exception to the dopamine theme has been selegiline, an irreversible inhibitor of monoamine oxidase type B (MAO-B), which finds use in both PD and major depressive disorder (Lee and Chen 2007).