Modern approaches to treatment of Parkinson's disease
Strachunskaya E.Ya., Gribova N.P.

Smolensk Medical University

The article is devoted to one of the commonest ubiquitous ailments – Parkinson's disease (PD). Its prevalence in Russia reaches 10% of the polulation. The number of patients with parkinsonism is growing, mainly due to spread in working age group. The article provides a thorough review of pharmacokinetics, pharmacodynamics, effects, data on clinical investigations, untoward reactions, and interactions of antiparkinson drugs: dopamine-containing, agonists of dopamine,  MAO-B inhibitors, anticholinergic and combined drugs. The article also focuses on the non-pharmacological methods of treatment of patients with parkinsonism: surgery (stereotactic destruction of ventrolateral nucleus of the optic thalamus), physical exercises for improvement of motility and of daily activities, in spite of movement limitations linked with the disease.
The effectiveness of therapy for PD should be based on individual approach depending on the stage of the disorder, severity of clinical signs and on lack or absence of the complications. The article presents a tool “Expenses-Usefulness” for assessing treatment of patients with parkinsonism.  The information system of multi-criteria analysis can be viewed as a option for support of decision-making when choosing a life-long therapy for patients with parkinsonism.

Key words: Parkinson's disease, dopamine, MAO-B inhibitors, Piribedil, Amantadine, QALM.
For citation: Strachunskaya E.Ya., Gribova N.P. Modern approaches to treatment of Parkinson's disease // RMJ. 2017. № 13. P. 957–962.