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Wirkverlust und „Therapieresistenz“

  • W. Poewe
Chapter

Zusammenfassung

In der Mehrzahl der Fälle gelingt es, mit einer der verschiedenen möglichen Strategien der Ersteinstellung eines Patienten mit idiopathischem Parkinson-Syndrom zu einem befriedigenden Therapieresultat zu gelangen. Bei L-Dopa-Monotherapie wird in Abhängigkeit von der gewählten Dosis innerhalb des ersten Behandlungsjahres bei bis zu 90% der Patienten ein ausreichender Effekt erzielt (Shaw et al. 1980, Poewe et al. 1986a, s. auch Tabelle 10.2). Ähnlich ist die Situation bei Kombinationsbehandlung von L-Dopa mit einem Dopamin-(DA)-Agonisten (Rinne 1989), während nur knapp 60% auf Monotherapie mit einem DA-Agonisten im ersten Jahr hinlänglich gut ansprechen (Lees und Stern 1983, Rascol et al. 1984). Amantadin als Monotherapie oder in Kombination mit einem Anticholinergikum führte in 70% zum erwünschten Effekt (Schwab et al. 1969, Parkes et al. 1970).

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