Parkinson's Disease – Motor Fluctuations — SCE Neurology MCQ

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ModerateMovement DisordersParkinson's Disease – Motor FluctuationsSCE Neurology

A 60-year-old man with Parkinson's disease on levodopa develops wearing-off motor fluctuations. NICE NG71 recommends offering adjunct therapy. Which class of medication is NOT recommended as an adjunct?

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Correct answer: E — Anticholinergic

Explanation lettering: C = shown as A · A = shown as B · E = shown as C · B = shown as D · D = shown as E

NICE NG71 recommends dopamine agonists, MAO-B inhibitors, or COMT inhibitors as adjuncts to levodopa for motor fluctuations. Amantadine may be considered for dyskinesia. Anticholinergics are not recommended as adjuncts for motor fluctuations and carry significant side-effect risks (cognitive impairment, constipation, urinary retention) particularly in older patients. A/B/C: All are recommended adjunct options per NICE NG71. E: Amantadine is recommended for dyskinesia management.

Reference: NICE NG71 Parkinson's Disease (2017)