Preladenant is a selective adenosine A2A receptor antagonist that has been investigated primarily for its potential in the treatment of Parkinson’s disease. It was developed to address motor symptoms, particularly motor fluctuations and dyskinesias, in patients receiving levodopa therapy. By blocking the A2A receptors in the brain, Preladenant helps modulate the basal ganglia activity, improving motor function without directly affecting dopamine receptors. It was studied as an adjunct therapy to levodopa-carbidopa, aiming to reduce off-time and enhance on-time without troublesome dyskinesia. Clinical trials explored its efficacy and safety in both early and advanced stages of Parkinson’s disease. Although development was discontinued due to lack of sufficient efficacy in later-stage trials, Preladenant contributed valuable insights into the role of A2A receptor antagonism in neurodegenerative movement disorders.