Treatment

Due to its chronic nature, Parkinson’s disease requires broad-based management including patient and family education, support group services, general wellness maintenance, exercise, and nutrition. At present, there is no cure for PD, but medications or surgery can provide relief from the symptoms.

Medications prescribed control symptoms, mostly by increasing the levels of dopamine in the brain. At certain points during the day, the helpful effects of the medication often wear off, and symptoms can return. If this happens to a patient their health care provider may need to change the:

  1. Type of medication
  2. Dose
  3. Amount of time between doses
  4. How the medicine is taken

Patients should work closely with their doctors and therapists to find a treatment program that works best for them. They should never change or stop taking any medications without talking with their doctor.

MEDICATION

Many medications can cause severe side effects, including hallucinations, nausea, vomiting, diarrhea, and delirium. Monitoring and follow-up by the health care provider is important. Eventually, symptoms such as stooped posture, frozen movements, and speech difficulties may not respond very well to drug treatment.

Medications used to treat movement-related symptoms of Parkinson’s disease include:

  1. Levodopa (L-dopa), Sinemet, levodopa and carbidopa (Atamet)
  2. Pramipexole (Mirapex), ropinirole (Requip), bromocriptine (Parlodel)
  3. Selegiline (Eldepryl, Deprenyl), rasagiline (Azilect)
  4. Amantadine or anticholinergic medications to reduce early or mild tremors
  5. Entacapone

Other medications may include:

  1. Memantine, rivastigmine, galantamine for cognitive difficulties
  2. Antidepressants for mood disorders
  3. Gabapentin, duloxetine for pain
  4. Fludrocortisone, midodrine, botox, sidenafil for autonomic dysfunction
  5. Armodafinil, clonazepam, zolpidem for sleep disorders

SURGERY

Surgery may be an option for some patients with Parkinson’s disease. These surgeries do not cure Parkinson’s, but may help ease symptoms.

  1. Deep brain stimulation involves placing electrical stimulators in specific areas of the brain that control movement.
  2. Another type of surgery destroys brain issues that cause Parkinson’s symptoms.

LIFESTYLE CHANGES

Lifestyle changes may be helpful for Parkinson’s disease:

  1. Good general nutrition and health. Changes in what patients eat or drink are needed if there are swallowing problems
  2. Exercising, but adjusting the activity level to meet changing energy levels
  3. Regular rest periods and avoiding stress
  4. Physical therapy, speech therapy, and occupational therapy