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Parkinson’s disease (PD) is a progressive neurodegenerative disease that affects people aged over 60 years old. It is characterized by a marked dopamine deficiency in the nigral striatal system. The clinical features of PD are tremor, bradykinesia, rigidity and postural instability. Currently, there is no cure for PD and various medications are available for the relief of motor symptoms.

Levodopa
Levodopa is a precursor of dopamine which converts to dopamine in the brain. Although it is effective in symptomatic control of motor symptoms, long-term use can accelerate the progression of motor fluctuations. Therefore, it is recommended that the initiation of levodopa treatment should be delayed as long as possible.

Dopamine agonists
Dopamine agonists bind to dopamine receptors in the brain similarly to levodopa. For early onset patients, dopamine agonists are effective in symptomatic control to delay the initiation of levodopa treatment. Ropinirole is indicated for the initial treatment of Parkinson’s disease as monotherapy. It is also indicated in combination of levodopa when motor fluctuations occur in levodopa treatment. Patients should be reminded to swallow the whole extended-release tablet, not to crush, divide or chew.