Comparative review of dopamine receptor agonists in Parkinson's disease

Limitations of long term levodopa therapy for Parkinson's disease represent a major problem in the management of many patients. Dopamine receptor agonists provide antiparkinsonian effects and their use is most clearly defined in the context of complications from levodopa therapy. As such, dopamine receptor agonists are useful adjunctive agents to levodopa. Because typical adverse effects of dopamine receptor agonists may differ from those of levodopa, combination therapy is often effective and well tolerated. A variety of dopamine receptor agonists, both ergot and non-ergot derivatives, are useful in the treatment of Parkinson's disease. Five dopamine receptor agonists are currently available for use throughout much of the world, and many more are in developmental phases. Varying pharmacodynamic and pharmacokinetic profiles allow selection of appropriate dopamine receptor agonists for specific clinical scenarios. Recently reported comparative studies also suggest certain prescribing recommendations.