22 mar 2010-- Several medications may be helpful in treating such non-motor symptoms of Parkinson's disease as erectile dysfunction and constipation, but there is insufficient evidence for certain treatments for other issues such as anxiety and urinary incontinence, according to an American Academy of Neurology (AAN) practice parameter published in the March 16 issue of Neurology.
Theresa A. Zesiewicz, M.D., of the University of South Florida in Tampa, and colleagues performed a literature search from 1966 to mid-2008 for clinical trials involving patients with Parkinson's. They found that sildenafil citrate has level C evidence supporting its potential benefit in treating erectile dysfunction and that polyethylene glycol also has level C evidence for treating constipation. In addition, they found that level B evidence suggests levodopa/carbidopa may be useful in treating periodic limb movements of sleep, and level A evidence supports considering modafinil for improving the subjective perception of excessive daytime somnolence. An earlier AAN practice parameter found that botulinum toxin should be considered for drooling. However, the authors could not find enough evidence to support or refute particular treatments for urinary incontinence, anxiety, or orthostatic hypotension. "Although common, non-motor symptoms of Parkinson's disease are underdiagnosed. There is a paucity of research concerning treatment of non-motor symptoms in Parkinson's disease. A concerted and multidisciplinary effort needs to be made toward finding treatments for non-motor symptoms in Parkinson's disease," the authors conclude. A number of co-authors reported financial relationships with various of pharmaceutical companies, publications, and associations.
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