Parkinson: Motor Symptom Treatments (Brief Version)
- ALI NAEIMI
- Oct 10, 2024
- 2 min read
Understanding Parkinson's Medications and Treatment Options
Parkinson's disease is a complex condition requiring tailored treatment plans that evolve as the disease progresses. Here’s a comprehensive guide to the leading medications and therapies available:
1. Types of Dopamine Medications
Parkinson's medications aim to increase dopamine levels in the brain. These include:
Levodopa: The most effective treatment, converted into dopamine in the brain. Common forms:
Levodopa/Carbidopa (Sinemet)
Levodopa/Benserazide (Prolopa)
Slow-release Levodopa (Sinemet CR)
Key Tips:
Best taken on an empty stomach 15–30 minutes before meals.
High-protein meals can reduce absorption.
Missing a dose? Take it as soon as you remember.
Side Effects:
Nausea, stomach upset, low blood pressure, and sleepiness.
Long-term use may lead to motor fluctuations or dyskinesia (increased movements).
Managing Side Effects:
Keep a diary to track medication effectiveness and off-periods.
Adjust doses with your doctor to balance benefits and side effects.
Dopamine Agonists: Medications like Pramipexole, Ropinirole, and Rotigotine (patch) mimic dopamine effects and have a stable, long-lasting impact.
Side Effects: Similar to levodopa, with unique risks like leg swelling or impulse control disorders (e.g., gambling, shopping urges).
MAO-Inhibitors (e.g., Selegiline, Rasagiline) and COMT-Inhibitors (e.g., Entacapone):
Extend dopamine's presence in the brain.
Common side effects include nausea, dyskinesia, and sleep disturbances.
2. Additional Medications
Amantadine: Useful for managing dyskinesia and fatigue. It may cause harmless skin discoloration (livedo reticularis).
Anticholinergics (e.g., Trihexyphenidyl, Benztropine): Effective for tremors but can cause memory loss, especially in older adults.
3. Advanced Therapies for Parkinson's
For advanced stages, specialized treatments may be recommended:
Deep Brain Stimulation (DBS)
It involves surgically implanting electrodes in the brain connected to a pulse generator in the chest.
It works like 24/7 electronic levodopa but won't help symptoms unresponsive to levodopa.
Considerations:
Suitable for carefully selected candidates under 70 years old.
Risks include infection, stroke, or cognitive issues.
Continuous Medication (Duodopa System)
Delivers levodopa-carbidopa gel directly to the small intestine via a pump.
Provides smoother symptom control with fewer side effects.
Maintenance:
Regular programming and care for the pump and tube.
Risks include infection or tube blockage.
4. Collaborative Care
As Parkinson's progresses, treatment plans will need frequent adjustments. Work closely with your care team to combine medications and therapies that suit your changing needs. Regular tracking and communication are essential for optimizing your quality of life.
For more details or personalized advice, consult your healthcare provider.
References: Parkinson Canada - Treatments
