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Review

Istradefylline to Treat Patients with Parkinson’s Disease Experiencing “Off” Episodes: A Comprehensive Review

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Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
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Soroka University Medical Center and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva 8410501, Israel
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School of Optometry, University of California, Berkeley, CA 94704, USA
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Department of Anesthesiology, Georgetown University School of Medicine, Washington, DC 20007, USA
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Department of Anesthesiology, LSU Health Shreveport, Shreveport, LA 71103, USA
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Department of Anesthesiology, University of Arizona College of Medicine—Phoenix, Phoenix, AZ 85004, USA
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Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE 68124, USA
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Valley Anesthesiology and Pain Consultants—Envision Physician Services, Phoenix, AZ 85004, USA
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Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA 02571, USA
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Author to whom correspondence should be addressed.
Neurol. Int. 2020, 12(3), 109-129; https://doi.org/10.3390/neurolint12030017
Received: 11 November 2020 / Revised: 30 November 2020 / Accepted: 1 December 2020 / Published: 8 December 2020
Parkinson’s disease (PD) is a common neurodegenerative disorder that leads to significant morbidity and disability. PD is caused by a loss of dopaminergic, cholinergic, serotonergic, and noradrenergic neurons in the central nervous system (CNS), and peripherally; the syndromic parkinsonism symptoms of movement disorder, gait disorder, rigidity and tremor are mostly driven by the loss of these neurons in the basal ganglia. Unfortunately, a significant proportion of patients taking levodopa, the standard of care treatment for PD, will begin to experience a decrease in effectiveness at varying times. These periods, referred to as “off episodes”, are characterized by increased symptoms and have a detrimental effect on quality of life and disability. Istradefylline, a novel adenosine A2A receptor antagonist, is indicated as a treatment addition to levodopa/carbidopa in patients experiencing “off episodes”. It promotes dopaminergic activity by antagonizing adenosine in the basal ganglia. This review will discuss istradefylline as a treatment for PD patients with off episodes. View Full-Text
Keywords: parkinsonism; levodopa; carbidopa; neurodegenerative; catechol-o-methyl transferase (COMT) parkinsonism; levodopa; carbidopa; neurodegenerative; catechol-o-methyl transferase (COMT)
MDPI and ACS Style

Berger, A.A.; Winnick, A.; Welschmeyer, A.; Kaneb, A.; Berardino, K.; Cornett, E.M.; Kaye, A.D.; Viswanath, O.; Urits, I. Istradefylline to Treat Patients with Parkinson’s Disease Experiencing “Off” Episodes: A Comprehensive Review. Neurol. Int. 2020, 12, 109-129. https://doi.org/10.3390/neurolint12030017

AMA Style

Berger AA, Winnick A, Welschmeyer A, Kaneb A, Berardino K, Cornett EM, Kaye AD, Viswanath O, Urits I. Istradefylline to Treat Patients with Parkinson’s Disease Experiencing “Off” Episodes: A Comprehensive Review. Neurology International. 2020; 12(3):109-129. https://doi.org/10.3390/neurolint12030017

Chicago/Turabian Style

Berger, Amnon A., Ariel Winnick, Alexandra Welschmeyer, Alicia Kaneb, Kevin Berardino, Elyse M. Cornett, Alan D. Kaye, Omar Viswanath, and Ivan Urits. 2020. "Istradefylline to Treat Patients with Parkinson’s Disease Experiencing “Off” Episodes: A Comprehensive Review" Neurology International 12, no. 3: 109-129. https://doi.org/10.3390/neurolint12030017

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