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Guidelines for the Use of Parkinsonian Drugs in Canada

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NeuroPsychopharmacotherapy

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Abstract

Drug therapies available for patients with Parkinson’s disease (PD) in Canada are similar to all other regions of the world where the primary focus is on dopamine replacement therapies predominantly with levodopa/carbidopa and levodopa/benserazide immediate release and controlled release levodopa/carbidopa. No other levodopa preparations are available. Dopamine agonists (DA), as monotherapy or adjunct therapy, are less commonly used due to the side effect profile. Longer-acting ropinirole and pramipexole, as well as apomorphine subcutaneous infusion pump therapy, are not available in Canada. For subjects with fluctuating symptoms, add-on therapies with monoamine oxidase B inhibitors (MAOB-I), rasagiline or selegiline, and the catechol-o-methyltransferase inhibitor (COMT-I), entacapone, are commonly used options. Other MAOB inhibitors and COMT-I are not easily available. Dyskinesia can be reduced with amantadine. There are no recommended drugs for disease modification available. For the many non-motor symptoms in PD, including neuropsychiatric symptoms, autonomic failure, pain, and sleep disorders, drugs used in non-PD areas available in Canada are used.

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Author information

Authors and Affiliations

  1. Division of Neurology, University of Toronto, Toronto, ON, Canada

    Susan H. Fox

  2. Movement Disorder Clinic, Edmond J Safra Program in Parkinson Disease, Toronto Western Hospital, Toronto, ON, Canada

    Susan H. Fox

  3. Section of Neurology, Division of Internal Medicine, University of Manitoba Rady Faculty of Health Sciences, Winnipeg, MB, Canada

    Sean Jeremy Udow

  4. Movement Disorders Clinic, Deer Lodge Hospital, Winnipeg, MB, Canada

    Sean Jeremy Udow

Authors
  1. Susan H. Fox
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  2. Sean Jeremy Udow
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Corresponding author

Correspondence to Susan H. Fox .

Editor information

Editors and Affiliations

  1. Dept Psychiatry , Psychosomatics & Psychotherapy, University of WĂĽrzburg, Medical School Clinical Neurochemistry, WĂĽrzburg, Germany

    Peter Riederer

  2. Inst fĂĽr Psychologische Medizin, Haag, Bayern, Germany

    Gerd Laux

  3. Department of Psychiatry, University of Toronto Department of Psychiatry, Toronto, ON, Canada

    Benoit Mulsant

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Fujita Health University School Medicine, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

Section Editor information

  1. Fujita Health University School of Medicine, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  2. Institute of Environmental Medicine, Nagoya University, Nagoya, Aichi, Japan

    Toshiharu Nagatsu

  3. Department of Physiological Chemistry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan

    Akira Nakashima

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Fox, S.H., Udow, S.J. (2020). Guidelines for the Use of Parkinsonian Drugs in Canada. In: Riederer, P., Laux, G., Mulsant, B., Le, W., Nagatsu, T. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_356-1

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  • DOI: https://doi.org/10.1007/978-3-319-56015-1_356-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56015-1

  • Online ISBN: 978-3-319-56015-1

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