Pharmacological Treatments of Parkinson's Disease: Preventing and Curing Approaches

Pharmacological Treatments of Parkinson's Disease: Preventing and Curing Approaches

Lahcen Tamegart, Mjid Oukhrib, Dia Eddine Oudghiri, Bilal El-Mansoury, Chakir Ibtissam, Ahmed Draoui, Hafida El Ghachi, Abdelali Ben Maloui, Abdelaati El Khiat, Halima Gamrani
DOI: 10.4018/978-1-6684-5156-4.ch013
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Abstract

Parkinson's disease (PD) is recognized as the second most common neurodegenerative disease after Alzheimer's disease. Parkinson's disease is a progressive disease characterized by a progressive loss of dopaminergic neurons of the black substance (SNpc) and dopamine deficiency in the striatal region as well as motor and non-motor symptoms. The main objective of Parkinson's research is to understand the pathogenesis, targets, and development of therapeutic interventions to control disease progression. The use of various agents could be a good strategy for the treatment of PD.
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2. Pharmacological Treatments Of Non-Motor Symptoms Of Pd

The non-motor symptoms (NMS) are neuropsychiatric disorders. NMS are more frequent in patients with a larger number of years of PD diagnosis and in older patients. It can be present at any phase of the disease, with early, premotor phases or finally leading to disability. Two causes are possible; the disease itself or drug-induced symptoms of mental disorders. The NMS contributes impaired quality of life, to severe disability, and shortened life expectancy as well as patient and caregiver’s well-being are affected. The most common NMS in PD are, anxiety, depression, psychosis, sleep disorders, pain, fatigue, autonomic dysfunction (Fernandes et al. 2021). The incidence of the both disorders in PD anxiety and depression varies considerably across different situations (Sauerbier et al. 2017). In this part, we developed the pharmacological treatments of anxiety, depression and psychosis.

The conventional pharmacotherapy treatment for NMS of PD is the anti-Parkinsonian medications in general; they are administered as first-choice, such us. levodopa, dopamine agonists, amantadine, anticholinergics, and monoamine oxidase type B inhibitors (MAOBIs). (Choi et al. 2020).

2.1. Anxiety

Serotonin–norepinephrine reuptake inhibitors (SNRIs) such as mirtazapine and venlafaxine as well as remain the first treatment of choice Benzodiazepines (diazepam, lorazepam, clonazepam); SSRIs serotonin selective reuptake inhibitors (SSRIs) stay the first treatment of choice in general (such us fluoxetine, sertraline, paroxetine, etc. Start at low doses.). Moreover, tricyclic antidepressants (TCAs) including amitriptyline and nortriptyline are commonly used in clinical practice as well. (Sauerbier et al. 2017).

2.2. Depression

Using tricyclic antidepressants (TCAs), SNRIs and SSRIs (e.g. venlafaxine). (Choi et al. 2020). In the early course of PD, the anti-parkinsonian drugs and particularytreatement other dopaminergic agents/drugs pramipexole, ropinirole can increase depression.(Bassetti 2011).

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