Levodopa-induced dyskinesias in Parkinson’s disease: emerging treatments

Figures & data

Table 1 Clinical trials for the treatment of LIDs in PD

Pharmacological class	Substance (references of completed clinical trials)	Outcome*
NMDA antagonists	Amantadine^Citation27^–^Citation33	Effective against LIDs, controversy concerning the duration of antidyskinetic effect
	ADS-5102^Citation34	NCT01397422 (ongoing trial)
	Remacemide^Citation35	No antidyskinetic effects
	Dextromethorphan^Citation37	Reduced dyskinesia by 30%–40%
	AVP-923	NCT01767129 (ongoing trial)
	Memantine^Citation40^–^Citation42	Possibly effective against LIDs, good tolerability and safety
	CP-101,606^Citation46	Mild antidyskinetic effect, no improvement in parkinsonism, side effects
	Neu-120	NCT00607451 (status unknown)
mGluR antagonists	AFQ056^Citation58,Citation59	Reduced established LIDs, no negative effect on parkinsonism, safety and tolerability concerns NCT01173731 (ongoing trial)
	Dipraglurant (AX48621)^Citation61	Improved parkinsonism and dyskinesia NCT01336088 (completed)
AMPA antagonists	Talampanel	NCT00108667, NCT00036296, NCT00004576 (all trials completed, but no published data available)
	Perampanel^Citation66^–^Citation68	No antidyskinetic effects
α2-adrenergic receptor antagonists	Idazoxan^Citation72,Citation73	Controversial results concerning effectiveness and adverse-effects profile
	Fipamezole^Citation74	Only partially effective NCT01149811, NCT01140841 (completed, no published data available)
Adenosine A2A receptor antagonist	Preladenant (Sch 420814)^Citation84,Citation85	Increase in dyskinesia rates, improvement in parkinsonism
	Istradefylline^Citation86^–^Citation90	Improvement in UPDRS, increased dyskinesia rates
	Tozadenant (SYN115)^Citation91	No effect in dyskinesia, improvement in parkinsonian symptoms
Nicotinic receptors agonists	Nicotine^Citation98,Citation100,Citation101	Serious adverse effects NCT00957918 (completed, no published data)
	SIB-1508Y	Very low tolerabilitya
Partial dopamine agonists	Aripiprazole^Citation105	Effective against LIDs, well tolerated
	Pardoprunox^Citation107,Citation108	Effective against LIDs and improvement in UPDRS motor score
	Aplindore	NCT00623324 (completed, no published data available)
Monoamine oxidase-B inhibitors	Selegiline^Citation111,Citation115,Citation116	Controversial results concerning efficacy against LIDs
	Rasagiline^Citation112	Partially effective against LIDs
	Safinamide^Citation114	Improvement of LIDs
5HT agonists	Tandospirone^Citation118	No antidyskinetic effects, worsening of parkinsonism
	Sarizotane^Citation119,Citation121,Citation122	Controversial results concerning efficacy against LIDs, probably not effective
	Piclozotan	NCT00623363 (completed, no published data available)
Other treatments	Valproate^Citation125	No antidyskinetic effect
	Gabapentin^Citation126	No antidyskinetic effect
	Zonisamide^Citation127	Dose-dependent effectiveness against LIDs
	Levetiracetam^Citation128^–^Citation130,Citation133	Only mild antidyskinetic effect
	Topiramate	NCT00296959 (early termination due to slow recruitment)
	ACR325 (odopidine)	NCT01023282 (completed, but no published data are available)

Notes:

a Study redesigned due to tolerability issues

* status verified on August 22, 2013.

Abbreviations: LIDs, levodopa-induced dyskinesias; PD, Parkinson’s disease; NMDA, N-methyl-d-aspartate; mGluRs, metabotropic glutamate receptors; AMPA, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid; 5HT, 5-hydroxytryptamine; UPDRS, Unified Parkinson’s Disease Rating Scale.

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