Treatment Options for Parkinson's Disease
While a cure for Parkinson’s disease (PD) has not yet been found, thanks to research conducted in recent decades, many treatments are available to help manage the condition. And because Parkinson's disease is a progressive disease, it’s important to begin treatment as soon as possible. Working together, you and your medical team will select the best treatment approach for you based on your symptoms and needs. Parkinson’s disease treatment options include:
Medications to Treat the Symptoms of Parkinson's Disease
There are a number of different kinds of medications available to treat the symptoms of Parkinson's disease. Most medications for Parkinson's disease treat dopamine deficiency by either helping to replace dopamine, preventing its breakdown, or mimicking its effects.
- Levodopa: medication that helps replace dopamine
Levodopa is a drug the body can convert into dopamine and is one of the most effective treatments for the symptoms of Parkinson's disease. However, as the disease advances, levodopa’s benefit becomes less predictable. The risk of complications, such as motor fluctuations (the “on-off” effect) and dyskinesias (involuntary movements), increases. This is why it has become common practice to look at other medications to use as individual therapies or in conjunction with levodopa. In some cases, the choice may be made to delay using levodopa in order to prolong its effectiveness in later stages of Parkinson's disease — especially in younger patients.
- Enzyme inhibitors: medications that help prevent the breakdown of dopamine
These medications target specific enzymes that regulate the levels of dopamine in the body. They may 1) stop the enzymes that break down levodopa (a drug the body can convert to dopamine); or 2) stop the enzymes that destroy dopamine. Examples of enzyme inhibitors include carbidopa, catechol-O-methyltransferase (COMT) enzyme inhibitors, and monoamine oxidase-B (MAO-B) enzyme inhibitors.
- MAO-B inhibitors, including AZILECT, block the actions of the MAO enzyme, type B, which is responsible for the majority of the breakdown of dopamine in the brain. When used as initial therapy to treat early symptoms of Parkinson's disease, MAO-B inhibitors help control motor symptoms and may delay the need for levodopa therapy. When prescribed along with levodopa, MAO-B inhibitors have also been shown to reduce “off” time.
- Dopamine agonists (DAs): medications that mimic the effects of dopamine
DAs work by attaching to dopamine receptor sites in the brain and mimicking the effects of dopamine. DAs may be used alone or in combination with levodopa, and they may reduce the required dosage of levodopa.
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Surgical Treatment for the Symptoms of Parkinson's Disease
Deep brain stimulation (DBS) is the most common surgical procedure used to treat the symptoms of Parkinson's disease. However, DBS is generally considered only if currently available medications are not effective or if your symptoms have progressed to the point that prescription medications no longer offer benefit.
In DBS, neurosurgeons implant an electrode into an area of the brain that affects movement. The electrode delivers a continuous high-frequency electrical stimulation, helping control the movement center in the brain. DBS frequently leads to a dramatic improvement in Parkinson's disease symptoms and may allow for a reduced dose of levodopa, which may improve levodopa-related side effects and complications. People with Parkinson's disease should always consult with a movement disorder specialist before considering this option.
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