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In Parkinson's disease, the focus has long been on motor symptoms and therapy with dopaminergic substances. In recent years, the importance of non-motor symptoms has been increasingly recognized, as they occur early in the course of the disease and restrict considerably the quality of life. However, this also made the need for treatment of non-dopaminergic deficits obvious. Adenosine A 2A receptor antagonists were identified as an additional therapy, since the adenosine A 2A receptors are non-dopaminergic and selectively localized in the basal ganglia. This means that the striato-thalamo-cortical loops can be modulated. An adenosine A 2A receptor antagonist was already approved in Japan in 2013 and in the USA in 2019 as an add-on to L-DOPA. Approval for this drug in Europe is expected in the near future. In this overview, we present the theoretical basis and current data on its efficacy and therapeutic use., Competing Interests: W. Jost ist oder war als Berater und Referent für folgende Firmen tätig: Abbvie, Bial, Desitin, Kyowa Kirin, Stada, UCB, Zambon L. Tönges erhielt Honorare als wissenschaftlicher Berater, für Vortrags- und Schulungstätigkeiten oder Autorenschaften von Abbvie, Bayer, Boehringer, Bial, Desitin, GE, Kyowa Kirin, Stadapharm, UCB Pharma und Zambon., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)