New drugs in the pipeline to tackle apathy, falls and dyskinesia in Parkinson’s

Swedish biotech company IRLAB Therapeutics is moving steadily forward with a new generation of Parkinson’s treatments designed to tackle some of the most frustrating and overlooked symptoms of the condition — apathy, falls, and levodopa-induced dyskinesia. These are the issues that most affect daily life but have few, if any, effective treatments today. One of IRLAB’s most exciting projects is IRL757, a potential treatment for apathy — that deep loss of motivation and initiative that can make everyday activities feel impossible. It’s one of the least understood non-motor symptoms in Parkinson’s, affecting as many as 70 percent of people at some stage of their condition. Unlike depression, apathy doesn’t necessarily bring sadness — it’s more like emotional flatness and lack of drive. At the moment, there are no approved medicines specifically for it. IRLAB is preparing to launch a Phase 1b clinical trial of IRL757 before the end of 2025. Early studies suggest it may help restore some of the brain’s ability to process motivation and decision-making signals, which are disrupted when dopamine-producing neurons begin to die. The upcoming trial will test safety and how the drug behaves in the body, paving the way for larger studies if the results are promising. The company is also developing another compound called pirepemat, aimed at reducing the risk of falls, which are a major cause of injury and hospitalisation in Parkinson’s. In earlier clinical studies, patients taking pirepemat experienced a notable drop in their fall rate — around 42 percent overall, and more than 50 percent among those who reached optimal blood exposure levels. That suggests the drug’s benefit depends heavily on precise dosing, something IRLAB plans to refine in its next round of testing. Falls are one of the biggest unsolved problems in Parkinson’s care. They often occur because of a combination of motor symptoms like balance issues and freezing, along with cognitive changes and low blood pressure. A medication that genuinely reduces falls could make a huge difference to independence and confidence for many people. IRLAB is also advancing mesdopetam, another experimental drug aimed at treating levodopa-induced dyskinesia — the involuntary, twisting or jerky movements that can develop after years of standard Parkinson’s treatment. These movements can be so disruptive that some people start cutting back their medication just to avoid them. Mesdopetam targets a specific type of dopamine receptor in the brain that may help smooth out the peaks and troughs of levodopa, reducing those unwanted movements without dulling the drug’s benefits. Together, these three candidates show a clear strategy: to go beyond the traditional focus on tremor and stiffness, and address the real-world symptoms that make living with Parkinson’s so difficult. While it’s still early days, the science behind each of these drugs is rooted in years of research into how dopamine and related brain pathways control motivation, balance and movement. If successful, IRL757, pirepemat and mesdopetam could fill some of the biggest treatment gaps in Parkinson’s care — tackling apathy, preventing falls, and easing dyskinesia. That’s an ambitious target, but for people living with Parkinson’s, it represents exactly the kind of progress the field needs: not just managing symptoms, but improving quality of life in ways that matter most.