Your Guide to Parkinson's Medications

Although there's no cure for Parkinson's disease, there are a number of medications available to help control the symptoms of this progressive illness.

Used alone or (more likely) in combination, these drugs allow your body to function better, which in turn helps you do the things you want or need to do.

People who have Parkinson's can help themselves by learning about how these medications work, what potential benefits they may provide, and what side effects they may cause. Then, when your doctor suggests a change or an addition to the drugs you're taking, you can make an informed decision on your treatment.


What Are the Symptoms of Parkinson’s Disease?

Dopamine Replacement Therapy

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Levodopa, or L-dopa as it's commonly known, is considered the gold standard treatment for Parkinson's disease and is the most commonly used medication for the condition.

The drug is converted into the neurotransmitter dopamine in the brain, which replenishes dopamine supplies that have been lost as the disease progresses. By doing so, L-dopa improves the motor symptoms of Parkinson's disease.

L-dopa is quite effective but can cause some significant side effects, including involuntary movements (known as dyskinesias). It's usually prescribed in combination with another drug called carbidopa that reduces those side effects.

Dopamine Agonists

The second most widely-used medications for Parkinson's disease are drugs called dopamine agonists. Instead of replacing dopamine in your brain, these drugs trick your brain into thinking it has enough dopamine. The drugs do this by binding to receptors meant for dopamine in the brain.

Dopamine agonists also help to alleviate the motor symptoms of Parkinson's disease. They can be used alone or in combination with L-dopa.

Common side effects of dopamine agonists include nausea, vomiting, and a drop in blood pressure. Some people may develop compulsive, risk-taking behaviors while taking these drugs, which can limit their use.

MAO-B Inhibitors

Monoamine oxidase inhibitors — known as MAO-B inhibitors — first were used as treatments for depression, but also are useful in treating Parkinson's disease. The drugs block your body's breakdown of the neurotransmitter dopamine in your brain, which helps to keep the dopamine supply higher and to reduce your symptoms of Parkinson's.

The MAO-B inhibitors used most often in Parkinson's include Eldepryl and Zelapar (selegiline) and Azilect (rasagiline). They can be prescribed alone or with other Parkinson's drugs, and side effects can include nausea, headaches, dry mouth, dizziness, insomnia, and loss of appetite.

Researchers have looked at whether MAO-B inhibitors actually can slow the progression of Parkinson's disease (rather than just improving symptoms), but have concluded there's no evidence of that. Nonetheless, the drugs do help to treat Parkinson's symptoms.

Other Medications

There are a number of other medications that are used in the quest to find that perfect balance of medication effectiveness with minimal side effects.

A group of medications called COMT inhibitors, for example, can help more L-dopa reach the brain by preventing the body from breaking it down. Comtan (entacapone), Tasmar (tolcapone), and Ongentys (opicapone) are examples of COMT inhibitors.

Symmetrel (amantadine) works by increasing the amount of dopamine made by your body and preventing your body from breaking down existing dopamine. It's used in early Parkinson's to treat symptoms, and also can help with involuntary movements from L-dopa.

Anticholinergics such as Cogentin (benztropine) aren't commonly used but can help some younger Parkinson's patients control tremors. They target another neurotransmitter in the brain — acetylcholine.

Finally, Exelon (rivastigmine), a drug belonging to the drug class cholinesterase inhibitors, is approved for the treatment of dementia in Parkinson's. It may help improve your memory and your daily functioning.

Make Informed Decisions

There are many medications available that can help control the symptoms of Parkinson's disease. Understanding what the various drugs do, and what you can do to get the most out of your medications, really can help you manage your condition.

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