Parkinson ’ s disease therapy update

Parkinson’s disease (PD) is a disorder resulting from the death of dopaminergic neurones in the substantia nigra, which is located within the basal ganglia. Patients classically present with poverty of movement (hypokinesia, eg, a shuffling gait), slowness of movement (bradykinesia), rigidity and resting tremor. Although the disease is predominantly a movement disorder, other problems frequently develop, including psychiatric and autonomic disturbances (see Panel 1, p2) and, later, drug-related effects. The condition progresses to cause significant disability. PD is the second most common neurodegenerative disease after Alzheimer’s disease, affecting 100–160 per 100,000 of the population. There is a slightly higher prevalence in men. Typically, a community pharmacy with 5,000 patients will serve between five and eight patients with PD. The rising incidence with age raises important public health questions for the future.