Abstract
Summary: The concept of cholinergic dominance constituting a rational basis for the use of anti‐cholinergic drugs in Parkinson's disease is referred to and the role of such drugs, physiotherapy, antidepressants and amantadine hydrochloride is discussed. The limited scope of the cholinergic blocking drugs in alleviating akinesia is stressed and the not infrequent occurrence of unpleasant side effects is mentioned together with means of combating such symptoms.Tricyclic anti‐depressants are recommended when depression is present.Amantadine hydrochloride provides an initial favourable response in up to 50–66% of patients although improvement may not be maintained. The relative freedom of amantadine from side effects and the greater potency by comparison with conventional anti‐Parkinsonian remedies represents an advance in treatment although the ultimate role of amantadine in relationship to L‐dopa remains uncertain. A daily dose of 200 mg is recommended.
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