Parkinson’s Disease Treatment & Medications

downloadWhat is Parkinson’s Disease

Unfortunately, there is no cure for Parkinson’s disease. However, some medications can help control the symptoms, and can help significantly. In some later stages of Parkinson’s disease, surgery may be a recommended to help lead normalized lives.

Your physician may recommend tat you make a certain lifestyle change, specifically changes that increase the amount of exercise and physical aerobics. IN some cases, your doctor may recommend physical therapy to focus on balancing and stretching. A speech-language pathologist may help improve speech issues.

Medications

Medication can be given to you to help manage problems with movement such as walking and tremors. These drugs will serve as dopamine replacement, which is the signaling chemicals (Neurotransmitter) in the brain.

People with Parkinson’s diseases have very low brain, dopamine concentrations. However domain can be given directly to the brain, and it can not enter the brain.

You may experience significant improvement in your symptoms after starting Parkinson’s disease treatment. Over time, the benefits of the medications tend to become fewer drugs, and the results are less consistent. Your symptoms may continue to be well-controlled.

L_Dopa PARKINSONSMedications that your doctor may give include:
Carbidopa-Levodopa – Levodopa is considered the most effective Parkinson’s disease drug, it is a natural chemical that goes to your brain and is converted into dopamine.
Levodopa is combined with Rytary, Sinemet, or called Carbidopa, which protects with the Levodopa form prematurely converting into dopamine outside the brain. Carbidopa also prevents or reduces the sides effects like nausea. Side effects may be orthostatic hypotension, lightheadedness, and nausea

However, after years of taking this drug the benefits would become less stable. and will wear off.
You may also have increased dyskinesia or involuntary movements after continually taking higher dosages of levodopa.

download (1)Carbidopa- Levodopa Infusion – A medication called Duopa was approved by the U.S Food and Drug Administration in 2015. Duopa is made from carbidopa and levodopa. However, it is administered through a feeding tube that delivers the medication, in the form of gel directly to the small intestine.

Duopa is considered an option for people who have advanced stages of Parkinson’s, still respond to Carbidopa-levodopa and have fluctuations. Because Dopa is infused on a regular base, the patients blood levels of the two drugs remain consistent.

Tube place the feeding tube in the patient, a small surgical procedure must be completed. There is a risk of having the tube fall out or infections at the infusion site.

L_Dopa PARKINSONSDopamine agonist – This is not like levodopa, dopamine agonist does not change into dopamine, it just mimics the dopamine effects on the brain.

A dopamine agonist is not as effective as levodopa in treating symptoms. However, it last longer and may be used with levodopa to smooth the on and off effects of levodopa.

Domine agonist includes several compounds such as ropinirole (Requip) pramipexole (Mirapex) and rotigotine (Neupro as a patch). A short-functioning injectable dopamine agonist, apomorphine (Apokyn), can be used for quick relief.

Some of the side effects of dopamine agonist are similar to carbidopa-levodopa, although additional side effects such as hallucinations compulsive behaviors such as hypersexuality, eating gambling, along with sleepiness may appear. If you are taking this medication and begin to behave out of character, you should talk to your doctor.

MAO-B inhibitors – These are drugs that include selegiline (Eldepryl, Zelapar) and rasagiline (Azilect). They stop the breakdown of dopamine by inhibiting the brain enzyme monoamine oxidase B (MAO -B). This enzyme metabolizes the brain dopamine. The side effects may be insomnia and nausea.

When adding carbidopa-levodopa, to these medications there is an increase the risk of hallucinations.
These pills are not often used in conjunction with most antidepressants and other narcotics due to potentially severe and rare reactions. You should check with your doctor before taking other medications with MAO-B inhibitors

Catechol- O- methyltransferase (COMT) inhibitors. Entacapone (Comtan) is major drug in this class. The drug mildly prolongs the effect of levodopa therapy by blocking the enzyme that breaks down dopamine.
Side effects including increased risk of involuntary movement’s dyskinesia, result in enhanced levodopa effects. Other side effects are diarrhea or other enhanced levodopa side effects.
Tolcapone (Tamar) is another COMT inhibitor that is prescribed very rarely due to the risk of severe liver damage and failure.

Anitchoilingerics are medications use for many years to help control tremors associate with Parkinson’ disease. There are several anticholinergic medications that are available for treatment, such as benztropine (Cogentin) or trihexyphenidyl.

However the benefits are modest compared to the side effects such as impaired urination, dry mouth confusion, hallucinations, and impaired memory.

Amantadine is prescribed to give short-term relief to symptoms of mild, early-stage Parkison’s disease. It may be given with carbidopa-levodopa treatment in the later progression of Parkinson’s disease to manage involuntary movements (dyskinesias) caused by carbidopa-levodopa. The side effects include skin mottling, that is the color purple, and ankle swelling or hallucinations.

Surgical Procedures

Deep brain stimulation (DBS) is a surgery win with a surgeon implant electrodes into specific parts of the brain. The electrodes are connected to a generator in the chest near the collarbone. The electrical pulses are sent to the brain to reduce Parkinson disease symptoms. Your doctor may need to adjust the setting, and you may need constant monitoring from the physician as surgery would include risk such as infections, brain hemorrhaging in strokes.

Deep brain stimulation is often an option for people with an advanced form of Parkinson’s disease and has unstable medication (levodopa) results. DBS can stabilize the functions and reduce dyskinesia.

DBS is not suitable for difficulties that don’t react to levodopa therapy apart from tremor. A tremor can be constrained by DBS even if the tremor is not very responsive to levodopa.

While DBS may provide continued benefit for Parkinson’s symptoms, it will not prevent Parkinson’s disease from progressing.


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