TREATMENT OF ADVANCED PARKINSON’S DISEASE AND
ASSOCIATED PSYCHIATRIC DISTURBANCES
GABRIELA MIHĂILESCU1,2, IOAN BURAGA1,2*, CRISTINA BĂETU1,2, MAGDA BURAGA1
1“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
2Colentina Clinical Hospital Bucharest – Neurology Department 1
*corresponding author: buragaioan@yahoo.com
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Abstract:
Parkinson’s disease is a neurodegenerative disease, with increasing incidence, but with important therapeutic development in
the last 50 years. Besides the 7 classes of oral medication used in all the stages of the disease, three types of invasive
treatment are reserved for the advanced stages of Parkinson’s disease, associated to the oral medication, or less frequent as
monotherapy: apomorphine, levodopa-carbidopa intestinal gel (Duodopa®) and deep brain stimulation (DBS). A careful
analysis of the patient, age, co-morbidities, psychosocial and economic factors is necessary to decide which treatment is
suitable in each case. To increase patients’ and caregivers’ quality of life associated non-motor symptoms should also be
treated, especially psychiatric disturbances (anxiety, depression, psychosis, and dementia) as well as comorbidities.






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