Novel Pharmacotherapies for L-DOPA-Induced Dyskinesia

Abstract

Dyskinesia or abnormal involuntary movement is an unfortunate consequence of long-term therapy with L-DOPA, a gold standard for the treatment of Parkinson’s disease (PD). L-DOPA-induced dyskinesia (LID) is affected by age of onset, duration and severity of PD, L-DOPA dose, as well as gender. The main treatment modality is reduction of L-DOPA dose. Although administration of apomorphine, amantadine, and clozapine may be helpful, more effective pharmacotherapies are urgently needed. Recent advances in our understanding of the pathophysiology of LID have led to suggestions of novel interventions. In this chapter, three classes of drugs, nicotinic receptor agonists, glutamatergic N-methyl-D-aspartate (NMDA) receptor antagonists, and cannabinoid receptor agonists, where their effectiveness in preclinical studies has been established, will be discussed in detail.