Обозрение психиатрии и медицинской психологии имени В.М. Бехтерева (Jul 2018)
Objectivization of efficiency of antiparkinsonian drug administration in correction of different types of tremor
Abstract
Clinical heterogeneity of tremor in Parkinson’s disease suggests a differentiated approach in choosing a correction therapy for motor defects. The article focuses on a variety of patterns of antiparkinsonian drug administration depending on the type and duration of tremor in patients with Parkinson’s disease. Reliable data on efficiency and advisability of the chosen therapy in the studied groups are provided. Findings: Most patients noted improvement - reduced tremor, improved movements - during the received therapy. The studied antiparkinsonian drugs reduce rest tremor, with the effect of levodopa being equivalent to that of dopamine agonists, however, the efficacy of dopamine agonists decreases, and that of levodopa increases, with age. The lowest efficiency in rest tremor was demonstrated by PK-Merz. In treatment of posturo-kinetic tremor cholinolytics proved more potent than in groups 1 and 2. Where antiparkinsonian drugs are not efficient enough in patients with posturo-kinetic tremor, a combined use of basic therapy and other antitremor drugs may be considered, such as propranolol, topamaks, primidon, etc.