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After nearly three decades of research, the advantages of continuous dopaminomimetic therapies in Parkinson disease are now widely accepted and have been a major impetus for the pharmaceutical industry to develop agents and formulations that provide steady drug delivery to the brain. The question that remains unsettled is how best to achieve this goal. Strategies that have been tested include controlled release oral levodopa/carbidopa formulations,1 IV or intraduodenal levodopa infusions,2,3 parenteral infusions of levodopa prodrugs or dopamine agonists such as apomorphine and lisuride,4,5 long-acting oral dopamine agonists,6 transdermal delivery of dopamine agonists,7 and inhibitors of dopamine catabolizing enzymes allowing longer presence of the transmitter at the synaptic cleft.8 Some of these approaches have made it to the market and are being used with various degrees of success, while others remain experimental largely because of impracticality of their delivery systems. Therefore, the search goes on for ways to stimulate striatal dopamine receptors …
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