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An Update on Nondopaminergic Treatments for Motor and Non-motor Symptoms of Parkinson’s Disease

Nondopaminergic neurotransmitters such as adenosine, norepinephrine, serotonin, glutamate, and acetylcholine are all involved in Parkinson's disease (PD) and promote its symptoms. Therefore, nondopaminergic receptors are key targets for developing novel preparations for the management of motor...

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Autores principales: Jing, Xiao-Zhong, Yuan, Xiang-Zhen, Luo, Xingguang, Zhang, Shu-Yun, Wang, Xiao-Ping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bentham Science Publishers 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514518/
https://www.ncbi.nlm.nih.gov/pubmed/35193486
http://dx.doi.org/10.2174/1570159X20666220222150811
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author Jing, Xiao-Zhong
Yuan, Xiang-Zhen
Luo, Xingguang
Zhang, Shu-Yun
Wang, Xiao-Ping
author_facet Jing, Xiao-Zhong
Yuan, Xiang-Zhen
Luo, Xingguang
Zhang, Shu-Yun
Wang, Xiao-Ping
author_sort Jing, Xiao-Zhong
collection PubMed
description Nondopaminergic neurotransmitters such as adenosine, norepinephrine, serotonin, glutamate, and acetylcholine are all involved in Parkinson's disease (PD) and promote its symptoms. Therefore, nondopaminergic receptors are key targets for developing novel preparations for the management of motor and non-motor symptoms in PD, without the potential adverse events of dopamine replacement therapy. We reviewed English-written articles and ongoing clinical trials of nondopaminergic treatments for PD patients till 2014 to summarize the recent findings on nondopaminergic preparations for the treatment of PD patients. The most promising research area of nondopaminergic targets is to reduce motor complications caused by traditional dopamine replacement therapy, including motor fluctuations and levodopa-induced dyskinesia. Istradefylline, Safinamide, and Zonisamide were licensed for the management of motor fluctuations in PD patients, while novel serotonergic and glutamatergic agents to improve motor fluctuations are still under research. Sustained-release agents of Amantadine were approved for treating levodopa induced dyskinesia (LID), and serotonin 5HT(1B) receptor agonist also showed clinical benefits to LID. Nondopaminergic targets were also being explored for the treatment of non-motor symptoms of PD. Pimavanserin was approved globally for the management of hallucinations and delusions related to PD psychosis. Istradefylline revealed beneficial effect on daytime sleepiness, apathy, depression, and lower urinary tract symptoms in PD subjects. Droxidopa may benefit orthostatic hypotension in PD patients. Safinamide and Zonisamide also showed clinical efficacy on certain non-motor symptoms of PD patients. Nondopaminergic drugs are not expected to replace dopaminergic strategies, but further development of these drugs may lead to new approaches with positive clinical implications.
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spelling pubmed-105145182023-09-23 An Update on Nondopaminergic Treatments for Motor and Non-motor Symptoms of Parkinson’s Disease Jing, Xiao-Zhong Yuan, Xiang-Zhen Luo, Xingguang Zhang, Shu-Yun Wang, Xiao-Ping Curr Neuropharmacol Medicine, Neurology, Pharmacology, Neuroscience Nondopaminergic neurotransmitters such as adenosine, norepinephrine, serotonin, glutamate, and acetylcholine are all involved in Parkinson's disease (PD) and promote its symptoms. Therefore, nondopaminergic receptors are key targets for developing novel preparations for the management of motor and non-motor symptoms in PD, without the potential adverse events of dopamine replacement therapy. We reviewed English-written articles and ongoing clinical trials of nondopaminergic treatments for PD patients till 2014 to summarize the recent findings on nondopaminergic preparations for the treatment of PD patients. The most promising research area of nondopaminergic targets is to reduce motor complications caused by traditional dopamine replacement therapy, including motor fluctuations and levodopa-induced dyskinesia. Istradefylline, Safinamide, and Zonisamide were licensed for the management of motor fluctuations in PD patients, while novel serotonergic and glutamatergic agents to improve motor fluctuations are still under research. Sustained-release agents of Amantadine were approved for treating levodopa induced dyskinesia (LID), and serotonin 5HT(1B) receptor agonist also showed clinical benefits to LID. Nondopaminergic targets were also being explored for the treatment of non-motor symptoms of PD. Pimavanserin was approved globally for the management of hallucinations and delusions related to PD psychosis. Istradefylline revealed beneficial effect on daytime sleepiness, apathy, depression, and lower urinary tract symptoms in PD subjects. Droxidopa may benefit orthostatic hypotension in PD patients. Safinamide and Zonisamide also showed clinical efficacy on certain non-motor symptoms of PD patients. Nondopaminergic drugs are not expected to replace dopaminergic strategies, but further development of these drugs may lead to new approaches with positive clinical implications. Bentham Science Publishers 2023-06-15 2023-06-15 /pmc/articles/PMC10514518/ /pubmed/35193486 http://dx.doi.org/10.2174/1570159X20666220222150811 Text en https://creativecommons.org/licenses/by/4.0/© 2023 The Author(s). Published by Bentham Science Publisher. This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
spellingShingle Medicine, Neurology, Pharmacology, Neuroscience
Jing, Xiao-Zhong
Yuan, Xiang-Zhen
Luo, Xingguang
Zhang, Shu-Yun
Wang, Xiao-Ping
An Update on Nondopaminergic Treatments for Motor and Non-motor Symptoms of Parkinson’s Disease
title An Update on Nondopaminergic Treatments for Motor and Non-motor Symptoms of Parkinson’s Disease
title_full An Update on Nondopaminergic Treatments for Motor and Non-motor Symptoms of Parkinson’s Disease
title_fullStr An Update on Nondopaminergic Treatments for Motor and Non-motor Symptoms of Parkinson’s Disease
title_full_unstemmed An Update on Nondopaminergic Treatments for Motor and Non-motor Symptoms of Parkinson’s Disease
title_short An Update on Nondopaminergic Treatments for Motor and Non-motor Symptoms of Parkinson’s Disease
title_sort update on nondopaminergic treatments for motor and non-motor symptoms of parkinson’s disease
topic Medicine, Neurology, Pharmacology, Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514518/
https://www.ncbi.nlm.nih.gov/pubmed/35193486
http://dx.doi.org/10.2174/1570159X20666220222150811
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