Parkinson’s Disease: Management, Medications, and Treatment Options

Parkinson’s disease is a neurological disorder that affects movement, causing tremors, stiffness, and difficulty with balance and coordination. It happens when certain cells in the brain that produce a chemical called dopamine start to die off. Dopamine is a neurotransmitter that helps control movement, so when there’s not enough of it, movement becomes difficult.^1,2

Living with Parkinson’s Disease

Living with Parkinson’s disease can be a challenging experience, both for the person with the disease and their loved ones. Parkinson’s disease affects everyone differently, but it commonly causes symptoms such as tremors, stiffness, and difficulty with movement, balance, and coordination.^1,2

In addition to these physical symptoms, people with Parkinson’s disease can also experience non-motor symptoms such as depression, anxiety, fatigue, autonomic dysfunction, constipation, and difficulty sleeping. These symptoms can have a significant impact on a person’s quality of life and make it difficult to perform everyday activities.^1,2

Parkinson’s disease is a progressive disease, which means that symptoms tend to worsen over time. This can be frustrating and make it challenging to plan for the future. It’s important for people with Parkinson’s disease to work closely with their healthcare team to develop a management plan that addresses their unique needs and concerns.^1,2

Support from family and friends can also be an important part of living with Parkinson’s disease. Talking openly about the disease and its impact on daily life can help loved ones better understand what the person with Parkinson’s is going through and how they can provide support. Support groups and community organizations can also be valuable resources for people living with Parkinson’s disease.

Managing Symptoms of Parkinson’s Disease

Managing the symptoms of Parkinson’s disease involves a variety of approaches, including medication, therapy, and lifestyle changes. Because Parkinson’s disease affects everyone differently, it’s important to work with a healthcare team to develop a personalized management plan.

Is There a Cure for Parkinson’s Disease?

Unfortunately, there is currently no cure for Parkinson’s disease. However, there are various treatments available that can help manage the symptoms and improve the quality of life for people with Parkinson’s. These treatments can include medications, therapies, lifestyle changes, and sometimes surgery.

Research is ongoing to find new treatments and potentially even a cure for Parkinson’s disease. Scientists are investigating different approaches, such as gene therapy, stem cell therapy, and deep brain stimulation. While there is still much to learn, these advances offer hope for the future.

Treatments for Parkinson’s Disease

There are several treatments available for Parkinson’s disease, and the right treatment plan depends on each person’s unique symptoms and needs. These treatments aim to control symptoms and improve the quality of life for people with Parkinson’s disease.

Medication for Parkinson’s Disease

Medication is one of the most common types of treatment for Parkinson’s disease. There are six main types of medication that can be used to treat the symptoms of Parkinson’s disease. These medications include levodopa, dopamine receptor agonists, inhibitors of enzymes that break down dopamine (known as MAO B inhibitors and COMT inhibitors), anticholinergic drugs, and amantadine.³

Levodopa

Levodopa is a medication commonly used to treat Parkinson’s disease. While it can be effective in improving movement symptoms like tremors, stiffness, and slowness, it can also have side effects. Some common side effects of levodopa include:

• Nausea and vomiting
• Low blood pressure
• Confusion or hallucinations
• Dyskinesia (involuntary movements)
• Dry mouth
• Sleep disturbances

Dopamine Receptor Agonists

These medications work by mimicking the effects of dopamine, a neurotransmitter that helps control movement in the brain. Dopamine receptor agonists can be used alone or in combination with other medications, such as levodopa. Some common side effects of dopamine receptor agonists include:

• Nausea and vomiting
• Dizziness or lightheadedness
• Sleep disturbances
• Confusion or hallucinations
• Impulse control disorders, such as compulsive gambling or shopping

Less common but more serious side effects may include low blood pressure, fainting, or difficulty breathing. It’s important to work closely with a healthcare provider when taking dopamine receptor agonists to monitor for side effects and adjust the dosage as needed.

Enzyme Inhibitors (MAO B Inhibitors and COMT Inhibitors)

Inhibitors of enzymes that break down dopamine, such as MAO B inhibitors and COMT inhibitors, are a type of medication used to treat Parkinson’s disease. These medications work by preventing the breakdown of dopamine in the brain, which can help improve movement symptoms like tremors, stiffness, and slowness.

MAO B inhibitors, such as selegiline and rasagiline, are often used in combination with other Parkinson’s disease medications. COMT inhibitors, such as entacapone and tolcapone, are typically used in combination with levodopa. Common side effects of MAO B inhibitors and COMT inhibitors include:

• Nausea and vomiting
• Diarrhea or constipation
• Dizziness or lightheadedness
• Sleep disturbances

Anticholinergic Drugs

Anticholinergic drugs are a type of medication used to treat Parkinson’s disease. These medications work by blocking the effects of acetylcholine, a neurotransmitter that can contribute to movement symptoms like tremors.

Anticholinergic drugs can be especially helpful for managing tremors in Parkinson’s disease, but they are generally less effective at treating other symptoms like stiffness or slowness.

While anticholinergic drugs can be effective in reducing tremors, they can also have side effects. Common side effects of anticholinergic drugs include:

• Dry mouth
• Blurred vision
• Constipation
• Urinary retention
• Confusion or memory problems
• Delirium

Amantadine

Amantadine is a type of medication that can be used to treat Parkinson’s disease. It works by blocking a certain type of receptor in the brain called the NMDA receptor, which can help improve movement symptoms like tremors, stiffness, and slowness.

Amantadine can be especially helpful for managing dyskinesias, which are involuntary movements that can occur as a side effect of other Parkinson’s disease medications.

Less common but more serious side effects may include difficulty breathing or heart problems. It’s important to work closely with a healthcare provider when taking amantadine to monitor for side effects and adjust the dosage as needed.

Treatment for Non-Motor Symptoms of Parkinson’s Disease

The following treatments are available to treat non-motor symptoms of Parkinson’s disease⁴:

Depression

People with Parkinson’s disease often experience depression, which is a common mental health problem. Fortunately, there are medications available to treat depression, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants. The best medication for an individual’s situation may vary, so it’s important to discuss treatment options with a healthcare provider.

Cognition (Memory-Associated Issues)

As Parkinson’s disease progresses and a person ages, they may experience difficulties with memory and thinking, known as dementia. Cholinesterase inhibitors, which were first used to treat Alzheimer’s disease, may help improve these symptoms in people with Parkinson’s.

Lifestyle Changes for Parkinson’s Disease

Making certain lifestyle changes can help relieve symptoms and improve the quality of life for people with Parkinson’s disease. These include⁵:

Exercise: Regular exercise can help improve mobility, balance, and coordination. People with Parkinson’s disease should aim for at least 30 minutes of exercise daily, such as walking, biking, swimming, or doing yoga.

Healthy diet: A well-balanced diet with plenty of fruits, vegetables, whole grains, and lean protein can help support overall health and well-being. Additionally, it may be helpful to work with a nutritionist or dietitian to ensure that you are getting all the necessary nutrients.

Managing stress: High levels of stress can worsen symptoms of Parkinson’s disease, so it’s important to find ways to manage stress, such as practicing relaxation techniques, getting enough sleep, and engaging in enjoyable activities.

Avoiding smoking and excessive alcohol: Smoking can worsen symptoms and increase the risk of other health problems, while excessive alcohol intake can interact negatively with Parkinson’s medications and worsen balance and coordination.

Strengthening social support: Staying connected with family, friends, and support groups can help reduce feelings of isolation and depression and provide a supportive network for managing the challenges of Parkinson’s disease.

Surgical Options for Parkinson’s Disease

In some cases, medications and lifestyle changes may not be enough to control the symptoms of Parkinson’s disease, and surgery may be an option. There are two main types of surgical procedures that are used to treat Parkinson’s disease: deep brain stimulation (DBS) and ablative surgery.⁶

Deep Brain Stimulation

DBS involves implanting electrodes into specific areas of the brain that control movement. These electrodes are connected to a device that sends electrical impulses to the brain. These impulses can help to reduce the tremors, stiffness, and other movement problems associated with Parkinson’s disease. The surgery is done under general anesthesia, and patients are usually able to go home the same day or the next day after the surgery. The device can be adjusted as needed to achieve the best results.

Ablative Surgery

This involves destroying a small area of the brain that is causing the symptoms of Parkinson’s disease. It is done using a surgical tool that uses heat, cold, or radiation. Ablative surgery is not as common as DBS because it is a more invasive procedure and has a higher risk of complications. However, it may be a good option for some patients who do not respond well to medication or DBS.

The Future of Parkinson’s Disease Treatments

One area of research focuses on developing drugs that could protect the dopamine-producing neurons in the brain and slow the progression of the disease. Another area of interest is the development of gene therapy, which involves altering the genes in brain cells to produce more dopamine and improve motor function.⁷

In addition to new drugs and therapies, there is also research being conducted on the use of stem cells for Parkinson’s disease. Stem cells are special cells that can develop into various cell types in the body, and researchers are exploring ways to use them to replace damaged or lost dopamine-producing neurons in the brain.⁷

Overall, there is still much work to be done — but the future of Parkinson’s disease treatments looks promising. With continued research and development, there is hope that we will one day find a cure for this debilitating disease.