Table 8. Conclusions on drugs to treat autonomic dysfunction in PD.

	Efficacy	Safety	Practice implications
Orthostatic hypotension
Fludrocortisone	Insufficient evidence	Insufficient evidence	Investigational
Domperidone	Insufficient evidence	Insufficient evidence	Investigational
Midodrin	Insufficient evidence	Insufficient evidence	Investigational
Dihydroergotamine	Insufficient evidence	Insufficient evidence	Investigational
Etilefrine hydrochloride	Insufficient evidence	Insufficient evidence	Investigational
Indomethacine	Insufficient evidence	Insufficient evidence	Investigational
Yohimbine	Insufficient evidence	Insufficient evidence	Investigational
L-threo-3.4-dihydroxyphenylserine	Insufficient evidence	Insufficient evidence	Investigational
Sexual dysfunction
Sildenafil	Insufficient evidence	Insufficient evidence	Investigational
Gastrointestinal motility problems (Constipation)
Macrogol	Likely efficacious	Acceptable risk without specialized monitoring	Possibly useful
Gastrointestinal motility problems (Anorexia, nausea and vomiting associated with levodopa and/or dopamine agonist treatment)
Domperiodone	Likely efficacious	Acceptable risk without specialized monitoring	Possibly useful
Metoclopramide	Insufficient evidence	Unacceptable risk	Not useful
Sialorrhea
Ipratropium bromide spray	Insufficient evidence	Insufficient evidence	Investigational
Glycopyrrolate	Efficaciousa	Insufficient evidence	Possibly useful
Botulinum toxin B	Efficacious	Acceptable risk with specialized monitoring	Clinically useful
Botulinum toxin A	Efficacious	Acceptable risk with specialized monitoring	Clinically useful
Urinary frequency, urgency, and/or urge incontinence
Oxybutynin	Insufficient evidence	Insufficient evidence	Investigational
Tolteradine	Insufficient evidence	Insufficient evidence	Investigational
Flavoxate	Insufficient evidence	Insufficient evidence	Investigational
Propiverine	Insufficient evidence	Insufficient evidence	Investigational
Prazosin	Insufficient evidence	Insufficient evidence	Investigational
Desmopressin	Insufficient evidence	Insufficient evidence	Investigational

Treatments with new conclusions have gray backgrounds and italicized text, and those with no changes have white backgrounds.

^aAlthough efficacious for the very short term, the study provides insufficient evidence for the treatment of sialorrhea in PD exceeding 1 week.

PD, Parkinson's disease.