| | | Rotigotine: The first transdermal nonergot-derived dopamine agonist for the treatment of Parkinson disease
| | | Parkinson disease (PD) is a chronic, progressive neurodegenerative disorder affecting approximately 1% of people aged >60 years. Levodopa has long been the cornerstone of PD treatment, but many patients receiving long-term levodopa therapy experience dyskinesia and motor fluctuations. Dopamine agonists act directly on dopamine receptors and are associated with a lower incidence of dyskinesias. There are 2 subclasses of dopamine agonists: ergot-derived and nonergot-derived. The use of ergot-derived dopamine agonists has declined in recent years due to the agents' association with valvular heart disease. Nonergot-derived dopamine agonists such as ropinirole and pramipexole are used more widely in the treatment of PD. Rotigotine is a nonergot-derived dopamine agonist that was approved by FDA on May 9, 2007, for the treatment of early-stage idiopathic PD. Rotigotine is the first approved nonergot-derived dopamine agonist that is delivered continuously through a transdermal silicone-based patch that is replaced.. |
| | | Psychosis-related disturbances
| | | Approximately 50% to 80% of persons diagnosed with Alzheimer's disease (AD) have some type of behavioral or psychiatric condition (eg, agitation, psychosis, and/or disinhibition). Agitation is defined in the context of restlessness, irritability, and resistiveness. Psychosis is recognized as a disturbance in the perception of objective reality. Disinhibition means a chronic loss of social restraint. In the case of AD, disinhibition can present as aggression, hyperactivity, and socially intrusive behavior. Such conditions can be burdensome for physicians and caregivers to manage. Consequences may include caregiver burnout or illness, patient abuse, and even institutionalization for the patient. Management of behavioral disturbances is no longer primarily handled by psychiatrists, but is now entering the realm of family practice and primary care. This article provides evaluation methods and treatment options for the aforementioned behavioral disturbances. |
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