A comparison between different anti-Parkinson medications

This study reviewed the effectiveness of dopamine agonists (DAg) and MAO-B inhibitors in the treatment of patients with Parkinson's disease (PD). Researchers suggested that DAgs and selegiline alone or with levodopa were the best options to treat these patients.

Parkinson's disease (PD) is a chronic disorder that affects the brain cells. These cells lose their ability to control body functions. The standard treatment for this disorder is levodopa. However, this therapy is associated with high levels of side effects. Therefore, new treatment regimens are necessary.

DAg works by imitating the actions of dopamine when levels are low. DAg include drugs such as cabergoline (Dostinex), pramipexole (Mirapex), rotigotine (Neupro), and ropinirole (Requip). MAO-B is a protein that breaks down dopamine. MAO-B inhibitors such as selegiline (Eldepryl), rasagiline (Azilect), and safinamide (Xadago) stop the action of this protein, making dopamine more available for the brain. This helps the body to fight the symptoms of PD. Prior studies suggested that both DAg and MAO-inhibitors could be good treatment options. However, so far there are no studies comparing the effectiveness of these two therapies.
 

This study reviewed 79 other studies comparing the effectiveness of different PD drugs. Patients received different DAg and MAO-B inhibitors alone or in combination with levodopa.

When analyzed drugs in monotherapy (one drug alone), DAg improved the treatment outcomes of patients with PD when given alone or in combination with levodopa. Ropinirole and levodopa had the best effects when taken alone. The MAO-B inhibitors selegiline and rasagiline also had positive effects on these patients. In contrast, safinamide was not associated with improved outcomes when compared to placebo.

Regarding combination therapy, selegiline combined with levodopa was the best treatment option of all drugs tested.

Higher rates of side effects were seen with pramipexole alone compared to placebo. However, no drug combination was associated with more side effects compared to placebo.

This study concluded that DAg and levodopa alone and selegiline combined with levodopa were the best treatment options for patients with PD.

This study did not compare drugs directly but from the results of different studies. Further controlled studies are necessary to confirm these results.