Transdermal rotigotine: a new non-ergot dopamine agonist for the treatment of Parkinson's disease

An important conceptual development to avoid the occurrence of motor dyskinesias in Parkinson's disease is continuous dopaminergic stimulation. Studies in animal models and humans suggest that continuous dopaminergic stimulation could be achieved by the infusions of different dopamine agonists or levodopa, and may significantly reduce the risk of dyskinesias associated with treatment strategies utilising pulsatile treatment options. However, so far, these techniques have either necessitated frequent intake of oral therapy or invasive parenteral treatment. The rotigotine transdermal delivery system represents a significant development that allows a constant delivery of a non-ergot dopamine agonist using a once-daily regimen, achieving steady plasma levels. Clinical trials demonstrate the efficacy of rotigotine in early and advanced Parkinson's disease, with important implications for treatment of non-motor symptoms of Parkinson's disease.