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The treatment of Parkinson s Disease (PD) remains largely symptomatic and it controls effectively motor symptoms of the disease for some years. This is a treatment that is considered basically substitute, which only acts on the nigrostriatal pathway but does not provide adequate plasma levels 24 hours a day in most cases. As a result, conventional medication, especially levodopa, produces pulsatile stimuli that with the progression of the disease is associated with the development of motor complications (Markham & Diamond, 1986). In recent years new formulations and alternative therapies (dopamine receptor agonists extended release, rotigotine patch, continuous infusion of apomorphine and continuous duodenal infusion of Duodopa) have been introduced in order to avoid pulsatile stimulation and thus prevent the "peaks " and "valleys" and achieve continuous dopaminergic stimulation to avoid, reduce or control the motor fluctuations and dyskinesias. Thus concept of continuous dopaminergic stimulation is born, which is not intended to restore modulatory physiological role exerted by dopamine on striatal function but to explain the benefits of using drugs that provide a more uniform and consistent dopamine stimulation, which has proven to be most appropriate and in practice more beneficial than traditional treatments. This review focuses on the treatment for symptomatic control of Parkinson's disease and complications from chronic treatment, the usefulness of new dopamine agonists and the beneficial effect of Duodopa as a possible alternative in the treatment of advanced PD compared with subcutaneous apomorphine infusion or deep brain stimulation of the subthalamic nucleus, this latter effective to control of motor complications but applicable to a very selective population with no cognitive or behavioral complications. It is clear that oral Levodopa combined with peripheral inhibitory amino-acid decarboxylase remains still the gold standard in the treatment of PD 40 years later after their use by Cotzias. However, chronic treatment with levodopa (LD) is related to the onset of motor complications in form of fluctuations in the response with wearing-off phenomenon and dyskinesia, which may occur after 3 to 5 years after the start of the LD (Markham & Diamond, 1986; Marsden, 1994). This variability in motor response is correlated with the

Advances in Drug Therapy: Alternative Treatments for the Control of Motor Fluctuations and Dyskinesias