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These comprise multiple drug classes which are approved for the condition, including levodopa, dopamine agonists, COMT inhibitors, MAO-B inhibitors, NMDA-receptor antagonists, anticholinergics, and others. Some of the drugs are approved for monotherapy and combination therapy while others are only approved as adjunctive therapy to levodopa. Furthermore, treatment for special treatment situations, e.g., rescue medication for off-phases, for tremor, treatment during pregnancy and breast feeding is discussed and recommendations are given with further details.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The recommendations were based on systematic literature reviews, drafted by expert teams, consented in online polls followed by online consensus meetings of the whole German Parkinson\u2019s Guideline Group, and publicly released in November 2023.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In the new S2k (i.e., consensus-based) guidelines, the pharmacotherapy of the motor symptoms of PD is discussed in five chapters. These comprise \u201cParkinson medication\u201d, \u201cInitial monotherapy\u201d, \u201cEarly combination therapy\u201d, \u201cFluctuations and dyskinesia\u201d, and \u201cParkinsonian tremor\u201d. Furthermore, there is a chapter for special treatment situations, including perioperative management, freezing of gait, and pregnancy and breastfeeding.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The recommendations for the pharmacotherapy of motor symptoms of PD have been updated. Newly available drugs have been added, while other drugs (e.g., ergoline dopamine agonists, anticholinergics, budipine) have been removed from the recommendations.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00415-024-12632-6","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T04:02:02Z","timestamp":1724904122000},"page":"7071-7101","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Pharmacotherapy of motor symptoms in early and mid-stage Parkinson\u2019s disease: guideline \u201cParkinson\u2019s disease\u201d of the German Society of 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Georg Ebersbach served as a consultant for AbbVie, BIAL, Desitin, STADAa, ESTEVE, Neuraxpharm, Boehringer; received honoraria for scientific presentations from AbbVie, BIAL, Britannia, Desitin, ESTEVE, Licher, STADA, Zambon; received publication royalties from Kohlhammer, Thieme, and Springer. Matthias H\u00f6llerhage served as a consultant for AbbVie; received honoraria for scientific presentations from AbbVie; received publication royalties from Thieme. G\u00fcnter H\u00f6glinger has ongoing research collaborations with Roche, UCB, AbbVie; served as a consultant for Abbvie, Alzprotect, Amylyx, Aprinoia, Asceneuron, Bayer, Bial, Biogen, Biohaven, Epidarex, Ferrer, Kyowa Kirin, Lundbeck, Novartis, Retrotope, Roche, Sanofi, Servier, Takeda, Teva, UCB; received honoraria for scientific presentations from AbbVie, Bayer, Bial, Biogen, Bristol Myers Squibb, Esteve, Kyowa Kirin, Pfizer, Roche, Teva, UCB, Zambon. received publication royalties from Academic Press, Kohlhammer, and Thieme. Dirk Woitalla served as a consultant for AbbVie, Bial, Esteve, StadaPharm, Zambone; received honoraria for scientific presentations from AbbVie, Daiichi, Desitin, Esteve, UCB, Zambone. All other authors declared no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}