Skip to main content

Advertisement

SpringerLink
Log in

Pharmacotherapy of Parkinson’s disease in Germany

  • ORIGINAL COMMUNICATION
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Treatment standards or guidelines have been developed for most features of Parkinson’s disease (PD). However, data on the actual treatment that is put into practice are scarce. In 2000, a nationwide survey on the topic of sudden onset of sleep (SOS) in PD was initiated among the members of the German patient support group (deutsche Parkinson–Vereinigung, dPV). A part of this mailed questionnaire survey covering the antiparkinsonian and concomitant medication of the participants is presented here. This study analyses data sets from more than 6,500 PD patients. The mean dopaminergic dose was equivalent to 599 ± 387 mg levodopa/die. The most frequently administered drugs were levodopa (94.2 %), dopamine agonists (DA) (71.7 %), amantadine (40.1 %), selegiline (27.6 %), entacapone (20.4 %), budipine (12.3 %), and anticholinergics (11.8 %). Costs of pharmacotherapy were estimated to be approximately € 399 million/year in Germany. PD drug therapy in general strongly depended on age, disease duration, and the level of care. The treatment guidelines were apparently not consistently followed underlining the need for their continuous propagation throughout the medical community. In addition our data suggest that non–motor symptoms in PD are not adequately treated and that concomitant sedative medication contributes to the occurrence of SOS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Askmark H, Antonov K, Aquilonius SM (2003) The increased utilisation of dopamine agonists and the introduction of COMT inhibitors have not reduced levodopa consumption–a nation-wide perspective in Sweden. Parkinsonism Relat Disord 9:271–276

    PubMed  Google Scholar 

  2. Brandstädter D, Oertel WH (2003) Depression in Parkinson’s disease. Adv Neurol 91:371–381

    PubMed  Google Scholar 

  3. Dodel RC, Berger K, Oertel WH (2001) Health-related quality of life and healthcare utilisation in patients with Parkinson’s disease: impact of motor fluctuations and dyskinesias. Pharmacoeconomics 19:1013–1038

    PubMed  Google Scholar 

  4. Dodel RC, Singer M, Köhne-Volland R, Szucs T, Rathay B, Scholz E, Oertel WH (1998) The economic impact of Parkinson’s disease. An estimation based on a 3-month prospective analysis. Pharmacoeconomics 14:299–312

    PubMed  Google Scholar 

  5. Donnan PT, Steinke DT, Stubbings C, Davey PG, MacDonald TM (2000) Selegiline and mortality in subjects with Parkinson’s disease. Neurology 55:1785–1789

    PubMed  Google Scholar 

  6. Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:427–442

    PubMed  Google Scholar 

  7. Bundesverband der pharmazeutischen Industrie (2000) Rote Liste. Rote Liste Verlag, Weinheim

  8. Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545

    PubMed  Google Scholar 

  9. Körner Y, Meindorfner C, Möller JC, Stiasny-Kolster K, Haja D, Cassel W, Oertel WH, Krüger HP (2004) Predictors of sudden onset of sleep. Mov Disord 19:1279–1284

    PubMed  Google Scholar 

  10. Leoni O, Martignoni E, Cosentino M, Michielotto D, Calandrella D, Zangaglia R, Riboldazzi G, Oria C, Lecchini S, Nappi G, Frigo G (2002) Drug prescribing patterns in Parkinson’s disease: a pharmacoepidemiological survey in a cohort of ambulatory patients. Pharmacoepidemiol Drug Saf 11:149–157

    PubMed  Google Scholar 

  11. LePen C, Wait S, Moutard-Martin F, Dujardin M, Ziegler M (1999) Cost of illness and disease severity in a cohort of French patients with Parkinson’s disease. Pharmacoeconomics 16:59–69

    PubMed  Google Scholar 

  12. Lienert GA, Krauth J (1974) Die Konfigurationsanalyse. IX. Auswertung multivariater klinischer Untersuchungspläne (Teil 1). Zeitschr Klin Psychol Psychother 22:3–17

    Google Scholar 

  13. Lozano AM, Lang AE, Galvez-Jimenez N, Miyasaki J, Duff J,Hutchinson WD, Dostrovsky JO (1995) Effect of GPi pallidotomy on motor function in Parkinson’s disease. Lancet 346: 1383–1387

    Article  PubMed  Google Scholar 

  14. Meissner W, Trottenberg T, Klaffke S, Paul G, Kuhn AA, Arnold G, Einhäupl KM, Kupsch A (2001) Apomorphine therapy versus deep brain stimulation. Clinical and economic aspects in patients with advanced Parkinson’s disease. Nervenarzt 72:924–927

    Article  PubMed  Google Scholar 

  15. Moro E, Scerrati M, Romito LMA, Roselli R, Tonali P, Albanese A (1999) Chronic subthalamic nucleus stimulation reduces medication requirements in Parkinson’s disease. Neurology 53:85–90

    PubMed  Google Scholar 

  16. Klinische “Leitlinien” der Deutschen Gesellschaft für Neurologie (2003) Leitlinien für Diagnostik und Therapie in der Neurologie. Thieme, Stuttgart

  17. Oertel WH, Quinn N (2002) Parkinsonism. In: Brandt T, Diener HC, Caplan LR (eds) Neurological disorders: course and treatment. Academic Press, San Diego, pp 1021–1079

  18. Oertel WH, Quinn NP (1996) Parkinsonism. In: Brandt T, Caplan LR, Dichgans J, Diener HC, Kennard C (eds) Neurological Disorders – Course and Treatment. Academic Press, San Diego, pp 715–772

  19. Olanow CW, Watts RL, Koller WC (2001) An algorithm (decision tree) for the management of Parkinson’s disease: treatment guidelines. Mov Disord 56:S1–S88

    Google Scholar 

  20. Pfeiffer RF (2003) Gastrointestinal dysfunction in Parkinson’s disease. Lancet Neurol 2:107–116

    PubMed  Google Scholar 

  21. Schwabe U (2001) Parkinsonmittel. In: Schwabe U, Paffrath D (eds) Arzneiverordnungsreport 2001. Springer, Berlin, pp 591–596

  22. Shabnam GN, Th C,Kho D, H R, Ce C (2003) Therapies for depression in Parkinson’s disease. Cochrane Database Syst Rev:CD003465

    Google Scholar 

  23. Siddiqui MF, Rast S, Lynn MJ, Auchus AP, Pfeiffer RF (2002) Autonomic dysfunction in Parkinson’s disease: a comprehensive symptom survey. Parkinsonism Relat Disord 8:277–284

    PubMed  Google Scholar 

  24. Singer C (1998) Urinary dysfunction in Parkinson’s disease. Clin Neurosci 5:78–86

    Article  PubMed  Google Scholar 

  25. Singer C, Weiner WJ, Sanchez-Ramos JR (1992) Autonomic dysfunction in men with Parkinson’s disease. Eur Neurol 32:134–140

    PubMed  Google Scholar 

  26. Slaughter JR, Slaughter KA, Nichols D, Holmes SE, Martens MP (2001) Prevalence, clinical manifestations, etiology, and treatment of depression in Parkinson’s disease. J Neuropsychiatry Clin Neurosci 13:187–196

    PubMed  Google Scholar 

  27. Spottke EA, Martin R, Berger K, Machat O, Oertel WH, Dodel RC (2002) Healthcare utilization and economic impact of Parkinson’s disease. Mov Disord 17(Suppl 5):S142

    Google Scholar 

  28. Spottke EA, Reuter M,Machat B, Bornschein B, Campenhausen S, Berger K, Koehne-Volland RK, Rieke J, Simonow A, Brandstädter D, Siebert U, Oertel WH, Dodel RD. Cost of illness and its predictors for Parkinson’s disease in Germany. Pharmacoeconomics: in press

Download references

Author information

Authors and Affiliations

  1. Dept. of Neurology, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany

    J. C. Möller, K. Stiasny-Kolster & W. H. Oertel

  2. Centre for Traffic Sciences, Julius-Maximilians-University, Würzburg, Germany

    Y. Körner, C. Meindorfner & H. P. Krüger

  3. Dept. of Neurology, Rheinische Friedrich-Wilhelms-University, Bonn, Germany

    R. C. Dodel & A. Spottke

Authors
  1. J. C. Möller
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Y. Körner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. C. Dodel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Meindorfner
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Stiasny-Kolster
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Spottke
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. H. P. Krüger
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. W. H. Oertel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. C. Möller.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Möller, J.C., Körner, Y., Dodel, R.C. et al. Pharmacotherapy of Parkinson’s disease in Germany. J Neurol 252, 926–935 (2005). https://doi.org/10.1007/s00415-005-0784-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-005-0784-1

Key words

Search

Navigation