Güneş M. , Karavana S. Y.

Turkish Journal of Pharmaceutical Sciences, vol.00, no.0, pp.1-20, 2021 (Other Refereed National Journals)

  • Publication Type: Article / Review
  • Volume: 00 Issue: 0
  • Publication Date: 2021
  • Doi Number: 10.4274/tjps.galenos.2021.95226
  • Title of Journal : Turkish Journal of Pharmaceutical Sciences
  • Page Numbers: pp.1-20


Parkinson’s disease (PD) is a type of movement disorder that affects the ability to perform daily activities. It is considered that 1 million people in the U.S. and more than 10 million people worldwide living with PD. It is a chronic and also progressive disease, so symptoms worsen over time. Patients experience motor symptoms such as tremors, stiffness and slow motion, and non-motor symptoms such as sleep problems, constipation, anxiety, depression and fatigue. Dopaminergic drugs are very important in the treatment of motor symptoms in PD. Levodopa is the ‘gold standard’ medication for the control of motor symptoms. As a result of the progression of the disease, the effectiveness of oral levodopa decreases over time and motor fluctuations such as ‘delayed ON’, ‘no ON’ and unpredictable ‘ON-OFF’ periods appear. These motor fluctuations affect the life quality of the patient at a high rate, and the patient has problems in fulfilling his daily morning routines. Gastrointestinal problems (GI), the common non-motor symptom, are the most important cause of motor fluctuations that occur as a result of inadequate oral treatment with the progression of PD. When oral treatments are not sufficient, non-oral treatments that are not affected by GI problems are required. In this review, the treatment strategies, developed and approved non-oral drug delivery systems in the early and advanced stages of PD are emphasized.