The latest pharmacological strategies for the management of levodopa-induced dyskinesias

Levodopa-induced dyskinesias (LID) is the most common side effect in Parkinson's disease (PD) treatment with dopaminergic and it seriously affect the patients' living quality. The underlying mechanism and pathological substrate of LID are not fully understood but animal models of parkinsonism with LID have provided important knowledge about the mechanisms underlying LID. Now in addition to adjust the treatment plan there is only a few drugs can relieve symptoms of LID and these drugs can not delay the course of the disease. So there is an urgent need for research on new drugs to make an intervention on its progress. Here we review the most relevant advances in relation to the dopaminergic system, the glutamatergic system, the serotonergic system, the opioid system, the GABAergic system, the adenosine system, the adrenergic neurotransmission and the related newly studied medicines to treat LID. Some of these drugs are not used clinically and only studied on animal models. Except for the classic medicines for LID treatment amantadine and morphine, there are also newly studied medicines such as mavoglurant and caffeine. For the classic druges there are newly studied dosage form for the sake of control the LID symptom rapidly or remission the pulsatile stimulation of DA receptors. The ultimate aim of this review is provide more choices for LID treatment and control the process of LID as soon as possible.