May

Introduction

The introduction to the Canadian market of three new drugs for the management of Parkinson’s disease (PD) in the last 2 years (one of which has been withdrawn due to rare hepatic toxicity) has left practitioners with a confusing array of choices. Here are two basic principles:

 Introduction

 Introduction

There are between 5000 and 8000 British Columbians with Parkinson's disease (PD). The vast majority of them are well treated with the medications outlined elsewhere in this issue of the British Columbia Medical Journal. A small portion of them, however, have symptoms that are refractory to these medications. Some of these symptoms can be exquisitely treated with neurosurgical techniques.

Introduction

The management of Parkinson’s disease (PD) today is a complex and demanding task as more treatment options become available. The patient often poses challenging problems, which may be derived from either their PD or its treatment. Levodopa-induced dyskinesia is one of most vexing problems facing physicians. This paper reviews recent developments on this issue and discusses the management of levodopa-induced dyskinesia.

Introduction

Parkinson's disease is commonly associated with psychiatric morbidity, which includes depression, anxiety, and dopaminergic psychosis. These compound the patient's predicament. Fortunately a variety of effective treatments is available. This article reviews the diagnosis and symptoms of depression, anxiety, and psychosis in Parkinson's disease, and offers strategies for effective management.

Depression