Dr.Raijput described in his own words the history of drug prescription in Parkinson's disease. Describing the unnoticed observation of the Vienna group in the early sixties. Giving the honor where it belongs. In his own department a long history of Parkinson treatment exists. Almost 1000 patients were seen over the last 22 years. Definitely showing the longer survival of the levodopa treated patients in the earlier stages of their disease and in those without dementia. From the beginning on, all routes were explored to increase dopamine in the striatum. The last years' attention has been focused on COMT-inhibitors. One of the arguments used is the prevention of levodopa induced fluctuations by improving the more stable continuous exposure of the receptors to dopamine.
All together a lot of the attention remains focused on symptomatic drug treatment. Where the basic cause is still unknown other routes are experimental. Progression is made in the basic field of application and formulation and new concepts about neuronal functions. We are waiting for a new break through, new concepts about the pathophysiology of this disabling disease.