Güneş M. , Karavana S. Y.

turkish journal of pharmaceutical science, vol.00, no.0, pp.1-31, 2021 (Journal Indexed in ESCI)

  • Publication Type: Article / Review
  • Volume: 00 Issue: 0
  • Publication Date: 2021
  • Title of Journal : turkish journal of pharmaceutical science
  • Page Numbers: pp.1-31


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.