Can Nicotine be Used Medicinally in Parkinson's Disease?

Claire Thiriez; Gabriel Villafane; Frédérique Grapin; Gilles Fenelon; Philippe Remy; Pierre Cesaro

Disclosures

Expert Rev Clin Pharmacol. 2011;4(4):429-436. 

In This Article

Five-year View

On the basis of clinical observation of single cases treated by transdermal nicotine, it appears that clinical response may vary to a major extent between individuals. This variability may be explained by different phenotypes in the clinical spectrum of PD. As growing evidence support the genetic susceptibility of most patients to PD, genetic differences on the disease itself or the pharmacological response of individuals to drugs can explain these major differences of clinical response between individuals.

The therapeutic role of nicotine may result from metabolic or receptor-mediated effects (vide supra). It is therefore probable that other nicotinic agonists, acting on one single receptor category or with one mechanism of action, will cross the gap between experimental research and clinical trials. One example is the recent study of two targeted nicotinic acetylcholine receptors agonists varenicline and A85380, which resulted in a significant decline in levodopa-induced abnormal involuntary movements at a relatively low dose of the agonist, with no worsening of Parkinsonism.[57] Finally, other tobacco smoke compounds may account, at least in part, for the neuroprotective effect.[58]

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