[Differential therapy of advanced Parkinson's disease with special reference to complementary therapeutic approaches].

In Parkinson's disease advanced symptoms (fluctuation, dyskinesia) and/or psychiatric side-effects of medication require a very individual and often complicated therapeutic regime. All pharmacological groups can be useful. The adjustment of medication needs clinical control, especially when psychiatric symptoms occur. Ideally, this task should be left to specially trained medical staff. Moreover, there are a number of complementary strategies recommended by various suppliers. Physiotherapy, speech therapy and ear acupuncture have in the past been shown to be useful even in advanced cases. The German Parkinson Society (dPV) has supported clinical trials in respect of the application of ear acupuncture, Qigong and the coenzyme Q10. Positive results are expected from Q10. Acupuncture cannot be recommended, while Qigong may be helpful for some patients.