Parkinson’s disease treatment

Because each person with Parkinson’s disease experiences a unique combination of symptoms, treatment plans are adjusted to address an individual’s needs and wants. You should always consult with your provider to discuss the possible side effects of treatments and determine which treatment option is right for you.

Parkinson’s disease medication

Your provider may prescribe the following medications for Parkinson’s disease:

Medication for Parkinson’s disease

There are many medications^[15] available for treating Parkinson’s disease. There is no cure or way to slow the progression of Parkinson’s disease, but there are treatments that can help manage a patient’s symptoms and improve their quality of life. As PD is primarily caused by the loss of dopamine production in the brain, most medications prescribed to treat the disease are medications that maintain or replenish dopamine or mimic the chemical’s actions.

• Carbidopa-Levodopa: Acts to replenish dopamine in the brain. The most commonly prescribed medication of this type is the bran Sinemet. Carbidopa is incorporated to help decrease the side effects of levodopa.

This medication can help^[16] alleviate rigidity and tremors that occur at rest. It does not typically help with non-motor symptoms, imbalance, or preventing falls. Rytary is a longer-acting form of carbidopa-levodopa medication—it can provide an additional one or two hours of relief from the symptoms of PD. As this medication is not available as a generic, however, it may be expensive.

• Dopamine receptor agonists: Your provider may prescribe a dopamine receptor agonist before starting you on levodopa. These medications mimic the effects of dopamine and can be used alone or in combination with levodopa or carbidopa-levodopa as a way to prolong their effects. Dopamine receptor agonists can help alleviate motor symptoms of PD, such as tremors, rigidity, impaired balance, and the loss of spontaneous movement.

Examples of dopamine agonists include pramipexole (Mirapex), ropinirole (Requip) and rotigotine (Neupro patch). Some common side effects^[17] of these medications include nausea, dizziness, leg swelling, sleepiness, hallucinations, worsening cognition, and impulse control disorders.

• Amantadine: Serves to boost existing dopamine levels in the brain. This medication can help somewhat in reducing motor symptoms in the early stages of Parkinson’s disease, but it is most helpful in treating involuntary bodily movements (dyskinesia). Currently prescribed versions include amantadine (generic Symmetrel), amantadine extended-release capsules (generic Gocovri), and amantadine extended-release tablets (generic Osmolex ER).
• Anticholinergics: These medications are prescribed to reduce tremors associated with Parkinson’s disease. Anticholinergics^[18] work by blocking the neurotransmitter acetylcholine, a chemical involved in sending messages from the brain to the muscles.

Anticholinergics are usually used in conjunction with other Parkinson’s disease treatments. Two commonly prescribed forms of this medication are benztropine (generic Cogentin) and trihexyphenidyl. Common side effects include blurry vision, dry mouth, constipation, and difficulty urinating. More serious side effects, including confusion and hallucination, are more common in people over 70.

• Monoamine Oxidase (MAO)-B inhibitors: These inhibitors block a key enzyme that breaks down dopamine, allowing the chemical to continue functioning in the brain for longer. Commonly prescribed forms include selegiline (generic Emsam, Zelapar), rasagiline (generic Azilect), and safinamide (generic Xadago).

These medications are typically the most effective when used in the early stages of Parkinson’s disease. Talk with your provider if you take medications for a diagnosed mood disorder, as there are potential drug interactions between MAO-B inhibitors and certain antidepressants (SSRIs).

• Catechol-O-methyltransferase (COMT) inhibitors: These inhibitors work in the same way as MAO-B inhibitors (by blocking enzymes that break down dopamine). They can also extend the effects of carbidopa-levodopa medications when taken together.

Commonly prescribed COMT inhibitors are entacapone (generic Comtan) and tolcapone (generic Tasmar). Only certain MAO-B inhibitors may be taken in combination with COMT inhibitors, such as safinamide (generic Xadago), rasagiline (generic Azilect), and selegiline (generic Emsam, Zelapar). Your provider may opt to start you on one or more of the medications listed above. It may take some time to determine what combination works best for maximizing benefits while keeping negative side effects to a minimum.