The management of Parkinsonian motor symptoms can be improved with the use of dopaminergic agents
. If alterations in dopaminergic medications fail to help EDS, one can consider adding a wakefulness promoting agent like modafinil.
Effects of the dopaminergic agent
and NMDA receptor antagonist amantadine on cognitive function, cerebral glucose metabolism and [D.sub.2] receptor availability in chronic traumatic brain injury: A study using positron emission tomography (PET).
When augmentation occurs, your usual dose of a dopaminergic agent
(most often seen with Sinemet) will allow you to obtain relief from your symptoms so that you will be able to sleep at night, but the sensations, the need to move, and the restlessness will develop (frequently with an increased intensity) earlier in the day (during the afternoon or even during the morning).
Most patients with RLS have a positive response to treatment with dopaminergic agents
, at least initially, and for many years carbidopa/levodopa was the usual therapy for RLS.
* Improve management of motor symptoms with dopaminergic agents
Other treatments such as oral medication that includes anticholinergic agents and dopaminergic agents
are used in combination.
Drug-induced blepharospasm is most usually associated with neuroleptics, dopaminergic agents
, antihistamines, calcium channel blockers, and noradrenaline and serotonin reuptake inhibitors (5).
For example, dopaminergic medications, particularly dopamine agonists, affect subjective sleepiness, and many dopaminergic agents
can be effective for treating RLS in patients with PD.
There are indirect evidences of dysregulation of the dopaminergic system in the pathogenesis of RLS, one of which is the clinical benefit of dopaminergic agents
in this population.
Furthermore, medications more recently approved by the US Food and Drug Administration (FDA) have left many health care providers confused about what constitutes appropriate first-, second-, and third-line therapies, as well as add-on therapy for symptoms secondary to dopaminergic agents
. What follows is a stepwise approach to managing PD that incorporates these newer therapies so that you can confidently and effectively manage patients with PD with little or no consultation.
are the gold standard treatment of RLS (4,29).
Pathological gambling behaviour: emergence secondary to treatment of Parkinson's disease with dopaminergic agents
. Depress Anxiety 2000; 11 (4): 185-186.