Guidelines for the Use of Parkinsonian Drugs in Canada

  • Susan H. FoxEmail author
  • Sean Jeremy Udow
Living reference work entry


Drug therapies available for patients with Parkinson’s disease (PD) in Canada are similar to all other regions of the world where the primary focus is on dopamine replacement therapies predominantly with levodopa/carbidopa and levodopa/benserazide immediate release and controlled release levodopa/carbidopa. No other levodopa preparations are available. Dopamine agonists (DA), as monotherapy or adjunct therapy, are less commonly used due to the side effect profile. Longer-acting ropinirole and pramipexole, as well as apomorphine subcutaneous infusion pump therapy, are not available in Canada. For subjects with fluctuating symptoms, add-on therapies with monoamine oxidase B inhibitors (MAOB-I), rasagiline or selegiline, and the catechol-o-methyltransferase inhibitor (COMT-I), entacapone, are commonly used options. Other MAOB inhibitors and COMT-I are not easily available. Dyskinesia can be reduced with amantadine. There are no recommended drugs for disease modification available. For the many non-motor symptoms in PD, including neuropsychiatric symptoms, autonomic failure, pain, and sleep disorders, drugs used in non-PD areas available in Canada are used.


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of NeurologyUniversity of TorontoTorontoCanada
  2. 2.Movement Disorder Clinic, Edmond J Safra Program in Parkinson DiseaseToronto Western HospitalTorontoCanada
  3. 3.Section of Neurology, Division of Internal MedicineUniversity of Manitoba Rady Faculty of Health SciencesWinnipegCanada
  4. 4.Movement Disorders ClinicDeer Lodge HospitalWinnipegCanada

Section editors and affiliations

  • Toshiharu Nagatsu
    • 1
    • 2
  • Akira Nakashima
    • 3
  1. 1.Fujita Health University School of MedicineToyoakeJapan
  2. 2.Institute of Environmental MedicineNagoya UniversityNagoyaJapan
  3. 3.Department of Physiological ChemistryFujita Health University School of MedicineToyoake, AichiJapan

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