Parkinson's disease (PD) is a neurodegenerative disorder that affects predominately dopamine-producing neurons in a specific area of the brain called substantia nigra. Symptoms develop slowly over years. The progression of symptoms is often a bit different from one person to another due to the diversity of the disease. People with PD may experience:
- Tremor, mainly at rest and described as pill rolling tremor in hands. Other forms of tremor are possible
- Slowness of movements
- Limb rigidity
- Gait and balance problems
The cause remains largely unknown. Although there is no cure, treatment options vary and include medications and surgery. While Parkinson’s itself is not fatal, disease complications can be serious. The Centers for Disease Control and Prevention (CDC) rated complications from PD as the 14th cause of death in the United States.
A number of medications are available for the management of both motor and non-motor symptoms of Parkinson's disease (PD). All of them are directed at easing symptoms and improving quality of life. At this time, no cure or disease-modifying therapy, one that stops or slows disease progression, has been proven. Significant research is ongoing in this area, though, as well as in the development of improved medications for motor symptoms and expanded options for non-motor symptoms. Drugs for motor symptoms primarily target tremor, stiffness and slowness while those for non-motor symptoms focus on the associated symptoms (such as depression, sleep disturbances and low blood pressure) that may arise throughout the course of disease. The medicines you take early on have a strong impact on how your condition will unfold over time.
Common Drugs for Parkinson's Disease
- Levodopa and carbidopa (Sinemet). Levodopa (L-dopa) is the most commonly prescribed medicine for Parkinson’s. It’s also the best at controlling the symptoms of the condition, particularly slow movements and stiff, rigid body parts. Levodopa works when your brain cells change it into dopamine. That’s a chemical the brain uses to send signals that help you move your body. People with Parkinson’s don’t have enough dopamine in their brains to control their movements.
- Safinamide (Xadago) is an add-on medicine that may be prescribed when individuals taking levdopoa and carbidopa have a breakthrough of Parkinson’s symptoms that were previously under control. Studies show that adding this drug helps individuals experience longer times with reduced or no symptoms. The most common side effects are trouble falling or staying asleep, nausea, falls, and uncontrolled, involuntary movements.
- Dopamine agonists. These drugs act like dopamine in the brain. They include ropinirole (Requip), pramipexole (Mirapex), and rotigotine (Neupro). You can take one of these drugs on its own or along with Sinemet. Most doctors prescribe dopamine agonists first and then add levodopa if your symptoms still aren’t under control. Dopamine agonists don’t have the same risks of long-term problems as levodopa therapy. So they are often the first choice of treatment for Parkinson's disease.
- Selegiline (Eldepryl, Zelapar) and rasagiline (Azilect). These drugs block the brain chemicals that break down dopamine. That helps your brain have more dopamine to work with. Some evidence shows that selegiline may slow the progression of Parkinson's disease, especially early on. Common side effects include nausea, dizziness or fainting, and stomach pain.
There is no best mix of Parkinson’s medicines. You and your doctor will have to try a few treatment approaches to figure out the best one for you. But there are some general guidelines for taking your medication. Be sure to ask your doctor or pharmacist for any specific tips for your treatment.