Treatments for Parkinsons

Treatment for Parkinson’s relies on a combination of lifestyle changes, medications, and
therapies.
Adequate rest, exercise, and a balanced diet are important. Speech therapy, occupational therapy, and physical therapy can also help to improve communication and self-care.
In almost all cases, medication will be required to help control the various physical and mental health symptoms associated with the disease.

Drugs and medication used to treat Parkinson’s disease

• Levodopa is the most common treatment for Parkinson’s. It helps to replenish dopamine. About 75 percent of cases respond to levodopa, but not all symptoms are improved. Levodopa is generally given with carbidopa. Carbidopa delays the breakdown of levodopa which in turn increases the availability of levodopa at the blood-brain barrier.
   
• Dopamine agonists can imitate the action of dopamine in the brain. They’re less effective than levodopa, but they can be useful as bridge medications when levodopa is less effective. Drugs in this class include bromocriptine, pramipexole, and ropinirole.
   
• Anticholinergics are used to block the parasympathetic nervous system. They can help with rigidity. Benztropine (Cogentin) and trihexyphenidyl are anticholinergics used to treat Parkinson’s.
   
• Amantadine (Symmetrel) can be used along with carbidopa-levodopa. It’s a glutamate blocking drug (NMDA). It offers short-term relief for the involuntary movements (dyskinesia) that can be a side effect of llevodopa.
   
• COMT inhibitors or Catechol O-methyltransferase (COMT) inhibitors prolong the effect of levodopa. Entacapone (Comtan) and tolcapone (Tasmar) are examples of COMT inhibitors. Tolcapone can cause liver damage. It’s usually saved for people who don’t respond to other therapies. Ectacapone doesn’t cause liver damage. Stalevo is a drug that combines ectacapone and carbidopa-levodopa inone pill.
   
• MAO B inhibitors or MAO B inhibitors inhibit the enzyme monoamine oxidase B. This
  enzyme breaks down dopamine in the brain. Selegiline (Eldepryl) and rasagiline (Azilect) are examples of MAO B inhibitors. Patients need to talk with doctor before taking any other medications with MAO B inhibitors.
   
• They can interact with many drugs, including:
  • antidepressants
  • ciprofloxacin
  • St. John’s wort
  • some narcotics

Over time, the effectiveness of Parkinson’s medications can decrease. By late-stage
Parkinson’s, the side effects of some medicines may outweigh the benefits. However,
they may still provide adequate control of symptoms.

Parkinson’s surgery
Surgical interventions are reserved for people who don’t respond to medication, therapy, and lifestyle changes. Two primary types of surgery are used to treat Parkinson’s:

• During deep brain stimulation (DBS), surgeons implant electrodes in specific parts of the brain. A generator connected to the electrodes sends out pulses to help reduce symptoms.
   
• Pump-delivered therapy, In January 2015, the U.S. Food and Drug Administration (FDA) approved a pump-delivered therapy called Duopa. The pump delivers a combination of levodopa and carbidopa. In order to use the pump, your doctor will have to perform a surgical procedure to place the pump near the small intestine.