What is the treatment for Parkinson's disease?

Treatment of Parkinson's disease. Treatment with medication is aimed at restoring the levels of dopamine in the brain and controlling symptoms.


There are six main groups of drugs:
• drugs which replace dopamine – these are the most commonly used treatments. They are combinations of levodopa – a drug which breaks down in the body to form dopamine, plus a chemical which ensures the optimum dopamine concentration in the brain. They are effective at treating symptoms, although there are some side-effects. These include nausea, dizziness and constipation. Also, they can cause long term problems such as unwanted movements of the face and limbs (dyskinesia) and they may become less effective over time.
• drugs which mimic the action of dopamine – e.g. bromocriptine. Using these early on in the course of Parkinson's disease may delay the long-term problems of the dopamine replacement drugs. Side-effects can include nausea and hallucinations.
• drugs which block the action of acetylcholine – e.g. benzhexol. These help to correct the balance between dopamine and another chemical in the brain called acetylcholine. Side-effects can include dry mouth and blurred vision. They are not appropriate for people over 70 as they can cause memory loss, and urine retention in men.
• drugs which prevent the breakdown of dopamine – e.g. selegiline. This gives a little relief from symptoms and is also a mild antidepressant. Low blood pressure and irregular heartbeat are the most significant side effects.
• amantadine – acts like a dopamine replacement drug but works on different receptors. It can cause side-effects such as sedation at high doses.
• COMT (catechol O-methyl transferase) inhibitors – e.g. tolcapone. This is a new class of drugs that stops the breakdown of dopamine. They are usually given when dopamine replacement drugs start to lose their effectiveness. They can affect liver function, so blood tests are needed for the first few months.


Surgery
This is currently used as a last resort when drugs no longer give benefits. Electrodes guided by X-rays (stereotactic surgery) are used to destroy the tiny areas of the brain responsible for tremor and abnormal movements.


A device called a deep brain stimulator can also be used to give the same effect as stereotactic surgery, without destroying brain tissue. Radiosurgery is a new technique currently available at only a few specialised centres. It uses high energy radiation to focus on very precise areas of the brain. A new treatment, where brain tissue from human foetuses is transplanted into diseased areas of the brain, is at the experimental stage.


Other therapies
Other therapies that have an important role in managing and coping with Parkinson's disease include physiotherapy, speech therapy, and occupational therapy. Staying active will help to maintain normal muscle tone and function. A doctor or physiotherapist can recommend an appropriate range of exercises and activities.
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Related Questions

What is the treatment for Parkinson's disease?

Neurologist. The first thing is to make the proper diagnosis. 32 is pretty young for parkinson's disease. There are other disorders that have some of the similar symptoms that have different treatments and prognosis. A neurologist is your point of contact to help with diagnosis and treatment. The mainstay of treatment is medications. When these fail, there are some that are amenable to surgery. Read more...
Initially medication. Many medications are employed for parkinson's, with perhaps the initial category, the Dopamine agonist and maybe azilect, (rasagiline) later on l-dopa, with carbi-dopa, and maybe entacapone. This can last for years, but late in the disease, a deep brain stimulator may be used. If this involves you or a family member, see a neurologist who has movement disorder experience. Read more...

What is the best new treatment for Parkinson's disease?

Parkinson's treatmen. Good question, but requites more info to answer meaningfully. The answer depends on the individual case. Age, other brain and neurologic factors, confirming diagnosis is correct, ruling out adverse drug effects causing parkinsonism, and more. Consider consulting a neurologist. There are various medications and sometimes surgeries. Read more...
Azilect (rasagiline) + Other Meds. Dopamine meds are mainstay of treatment. Modern therapy recommends longer lasting, milder potency meds first: Azilect (mao-b selective inhibitor) & Dopamine agonists (requip xl/mirapex er/neupro). After they've been maximized & stronger meds are needed to adequately manage symptoms, then sinemet +/- Comtan (stalevo (carbidopa and levodopa and entacapone) is both together) are begun. Tailor rx with side effects in mind for each person. Read more...

What is the treatment for early onset Parkinson's disease?

Medical management. People with parkinson’s disease may lose up to 80% of Dopamine in their bodies before symptoms appear. In addition, special imaging tests of the brain show that Dopamine may decline as much as 10% per year in people with parkinson’s disease. Early diagnosis and treatment are important to help minimize Dopamine loss in the brain and maintain muscle function. Best wishes. Read more...

What's the drug of choice in treatment of Parkinson's disease with a pregnant women?

Avoid amantadine. Please see your neurologist before starting therapy while pregnant. Amantadine has been linked to birth defects in pregnant women. Read more...