Current and Emerging Parkinson’s Medications

Extended-Release and Novel Levodopa Formulations

Levodopa, combined with carbidopa, remains the most effective agent for controlling motor symptoms. However, traditional immediate-release forms require frequent dosing and can lead to motor fluctuations (“on-off” effects).

IPX203 (Crexont): Recently approved in 2024, this extended-release levodopa/carbidopa pill allows less frequent dosing while increasing "on" time—periods of good symptom control—by about 1.5 hours compared to standard immediate-release forms [1], [3].

Vyalev (Produodopa): A new levodopa formulation delivered as a continuous subcutaneous infusion via a portable pump, providing steadier medication levels and improving motor fluctuations and early morning “off” times. Approved in some regions in 2024 [2].

Continuous Infusions and Delivery Systems

Motor fluctuations and variability in medication absorption are challenges with oral therapy. Continuous infusion approaches maintain stable dopamine levels:

ND0612: A subcutaneous infusion of carbidopa/levodopa delivered through a pump-patch attached to the skin. Shows promise in reducing motor fluctuations and is pending regulatory approval [1], [2].

Continuous Apomorphine Infusion: Delivered under the skin via pump, apomorphine is a dopamine agonist that helps reduce off times. This delivery system is approved in Europe and under FDA review in the US [2], [3].

New Dopamine Agonists and Symptom Targeting

Tavapadon: A selective dopamine receptor agonist designed to minimize side effects often seen with other dopamine agonists, such as impulsive behaviors and hallucinations. It has shown promising results in late-stage trials [2].

Antidyskinesia Therapies: Medications targeting dyskinesia (involuntary movements related to long-term levodopa use) such as CPL'36 and mesdopetam are in clinical trials, aiming to improve motor control without added side effects [2].

Investigational Disease-Modifying Therapies

Unlike symptom-focused treatments, these agents aim to slow or stop PD progression:

Neurotrophic Factors: Drugs like AB-1005 (a GDNF delivery system) may support neuronal survival and reduce dopamine loss [2].

Anti-Inflammatories: Targeting inflammatory pathways such as NLRP3 inflammasome inhibitors to prevent dopamine neuron damage [2].

Alpha-Synuclein Targeting: Experimental antibodies (e.g., prasinezumab) and drugs aimed at reducing alpha-synuclein aggregation are under investigation, though some early trials have not met endpoints but continue to be refined [2].

Genetics-Based Approaches: Compounds targeting mutations in genes like GBA and LRRK2 show potential for neuroprotection and motor function improvement. Clinical trials are ongoing [2].

GLP-1 Agonists (Diabetes Drugs): Drugs such as exenatide and liraglutide have been studied for potential disease-modifying effects with mixed results; research continues [2].

Practical Considerations and Clinical Participation

Participation in clinical trials remains vital to advance these therapies from experimental to approved treatments. Patients interested should discuss clinical study opportunities with their neurologist. Awareness of drug side effects, especially with new formulations and delivery methods, is important because of individual variability in response.

Last changed:

11/8/25, 1:54 PM