Parkinson Disease Guidelines

Updated: Sep 10, 2018
  • Author: Robert A Hauser, MD, MBA; Chief Editor: Selim R Benbadis, MD  more...
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Guidelines

Guidelines Summary

American Academy of Neurology (AAN)

In 2010, the AAN released guidelines on the treatment of nonmotor symptoms of Parkinson disease. Recommendations included the following [48] :

  • Sildenafil citrate (Viagra) may be considered to treat erectile dysfunction

  • Polyethylene glycol may be considered to treat constipation

  • Modafinil should be considered for patients who subjectively experience excessive daytime somnolence

  • For insomnia, evidence is insufficient to support or refute the use of levodopa to improve objective sleep parameters that are not affected by motor symptoms; evidence is also insufficient to support or refute the use of melatonin for poor sleep quality

  • Levodopa/carbidopa should be considered to treat periodic limb movements of sleep in Parkinson disease, but there are insufficient data to support or refute the use of nonergot dopamine agonists to treat this condition or that of restless-legs syndrome

  • Methylphenidate may be considered for fatigue (note: methylphenidate has the potential for abuse and addiction)

  • Evidence is insufficient to support or refute specific treatments of orthostatic hypotension, urinary incontinence, anxiety, and RMD