Manage motor fluctuations in Parkinson’s disease by taking a hierarchical approach and individualizing treatment

Abstract

Long-term levodopa therapy for Parkinson’s disease is associated with the development of motor fluctuations and other disabling effects. Adjunctive oral, transdermal and device-aided pharmacological treatments, as well as surgical therapies, may be used to manage motor fluctuations. Treatment should be individualized based on the efficacy and safety profiles of the intervention, as well as the clinical characteristics and preferences of the patient, and be adjusted as necessary to manage treatment-related adverse events.