Parkinson's disease treatments

The mainstay of Parkinson’s treatment is prescribed medication. But, beyond medicine, there are many supportive therapies that may help with symptom management, with the aim of preserving your independence and maintaining, or improving, your quality of life.

Overview of Prescribed Medicines for Parkinson’s

While there is currently no cure for Parkinson’s disease, there are numerous effective treatments available, and research is ongoing to find further new medicines.

With existing treatment options, symptoms can generally be controlled over the long-term. Here we describe the most common treatments, and how they work.

There are several different types of Parkinson’s medication. These fall broadly into the following categories:

• Levodopa
• Dopamine agonists
• COMT (catechol-O-methyl transferase) inhibitors
• MAO-B (monoamine oxidase B) inhibitors
• Anticholinergics

The availability of treatments can vary depending on the country you live in, and brand names can also differ from country to country. For more information about which medicines are available where you live, contact details for your national regulatory authority can be found here.

This is the most common medication prescribed to treat Parkinson’s and has been used for around fifty years.

Levodopa acts by crossing the blood-brain barrier, where it is converted into dopamine. It replaces the dopamine in the brain that is lost when a person has Parkinson’s.

Levodopa treatments for Parkinson’s are always combined with either carbidopa or benserazide. These prevent levodopa from being metabolised in the body, to allow more to reach the brain.

Levodopa treatments can be given either by mouth (orally) or using a gel that is administered into the intestines using a tube (intestinal infusion). Oral medication may be prescribed earlier on, and if it is not adequately controlling your symptoms, your doctor may recommend that it is delivered by a different route so that your symptom control is continuous.

These can be delivered orally, through the skin using a patch (transdermally) or using a needle to deliver it under the skin (subcutaneously). Dopamine agonists mimic dopamine.

Unlike levodopa, dopamine agonists do not need to be converted into dopamine by the brain first. They may be prescribed initially to delay the need for levodopa, or in combination with levodopa to treat the side effects of long-term treatment.

This type of Parkinson’s treatment prolongs the effects of levodopa by blocking an enzyme called catechol-O-methyl transferase (COMT). COMT breaks down levodopa. That’s why blocking it slows the destruction of levodopa in the body.

This class of medication is used to treat early Parkinson’s symptoms, as well as levodopa-induced motor fluctuations in advanced Parkinson’s. MAO-B inhibitors block an enzyme called monoamine oxidase B (MAO-B) which breaks down dopamine in the brain.

MAO-B inhibitors can extend the efficacy or reduce the required dose of co-careldopa treatment.

This is an older class of medication used to treat Parkinson’s. Anticholinergics reduce the amount of acetylcholine in the body to facilitate dopamine cell function. They are generally taken orally, but procyclidine can also be delivered via injection.

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As you can see from the above, there are many treatment options for Parkinson’s, which can be used at different disease stages to optimise symptom control, and in response to your individual needs and any changes in your symptoms.

It’s important that you try to attend all scheduled appointments with your healthcare team, so that they can monitor your symptoms, and see how you’re getting on with your treatment, in case you could benefit from any dose adjustments.