What is Parkinson’s?
Parkinson’s disease is a brain disorder that causes movement problems like a slow, shuffling walk, loss of balance and coordination, and tremors. Anyone can get Parkinson’s, though it usually occurs in older people.
Parkinson’s disease is caused by changes in your brain. Movement is controlled by nerve cells that release a chemical called dopamine. In people with Parkinson’s, these nerve cells die and cause reduced levels of dopamine, leading to problems with nerve signals and muscle movement.
Clumps of proteins called Lewy bodies also collect in the brain and cause dementia: memory loss and trouble thinking. Studies suggest gene changes might cause these proteins to clump together and cause Parkinson’s disease. Exposure to toxins and head injuries might also be risk factors for Parkinson’s disease.
What is the best treatment for Parkinson's disease?
There is no cure for Parkinson’s disease, but medications, therapy, and lifestyle changes can improve your symptoms. Medications raise your dopamine levels, change other brain chemical levels, and treat other symptoms like blood pressure, constipation, and trouble sleeping.
Almost everyone with Parkinson’s disease will eventually end up taking levodopa, which is an amino acid precursor to dopamine. Your cells absorb the medicine and convert it to dopamine, so it raises your dopamine levels.
It’s often used in combination with another drug called carbidopa that slows down dopamine conversion in your blood so that more of it reaches your brain. Carbidopa also stops common side effects of levodopa like nausea and vomiting.
Levodopa also commonly causes a condition called dyskinesia, where you have uncontrollable and jerky movements. Another side effect is called the “on-off” phenomenon, where you quickly switch between moving and being unable to move.
Dopamine agonists stimulate areas of your brain that use dopamine, so it has a similar but milder effect as levodopa.
Dopamine agonists can cause hallucinations where you see things that aren’t there, though, and experience compulsive urges like an impulse to gamble or shop excessively. They can also make you sleepy, dizzy, and nauseous.
Common dopamine agonist drugs include:
Catechol-O-methyltransferase (COMT) inhibitors block the COMT enzyme that breaks down levodopa in your body. It’s common to need higher doses of levodopa as your disease gets worse and more cells die, so COMT inhibitors can be used to prolong its effects. They’re often used in later stages of Parkinson’s to stop levodopa from wearing off so quickly.
These inhibitors include:
These medications don’t change your dopamine levels. Instead, anticholinergic drugs block a brain chemical called acetylcholine that affects movement. These medications can help with tremors and uncontrollable muscle contractions.
Types of anticholinergic drugs include benztropine and trihexyphenidyl hydrochloride.
Monoamine oxidase type B is an enzyme that breaks down dopamine and other brain chemicals. Inhibitor drugs block the enzyme, which makes more dopamine available to your brain. MAO-B inhibitors are often used in early stages of Parkinson’s and can be used alone or with levodopa and dopamine agonists.
These medicines are called:
What is the latest treatment for Parkinson’s?
Research for new Parkinson’s drugs and therapies is ongoing. Most people live a long time with Parkinson’s disease, which means you might take medications for a long time. All of these main treatments cause side effects that are hard to live with, so new drugs to treat those side effects are also being studied.
Adenosine A2a antagonists
This medication was approved by the FDA in 2019 for Parkinson’s disease as additional treatment alongside levodopa. It works by blocking a protein called the adenosine A2 receptor, which increases dopamine signaling. These medications lower off time and uncontrollable, jerky movements.
There are clinical trials and research happening for other therapies, including:
- Stem cell therapy that uses healthy cells to repair damage from Parkinson’s
- Growth factors, which are proteins that support nerve cells and promote growth and survival
- Gene therapy to reprogram cells to stay healthy and work better for longer
- Drugs for side effects like NLX-112 that targets certain serotonin receptors
Can Parkinson’s be cured?
There is no cure for Parkinson’s disease, but treatment can ease your symptoms. Your doctor will tailor treatment to your symptoms and your disease stage. If you think you have Parkinson’s disease symptoms, talk to your doctor.
JOHNS HOPKINS MEDICINE: "Parkinson's Disease Risk Factors and Causes."
Molecular Neurodegeneration: "Alpha-synuclein structure and Parkinson's disease – lessons and emerging principles."
National Health Service: "Parkinson's disease," "Parkinson's disease – Treatment."
National Institute of Health National Institute on Aging: "Parkinson's Disease."
Parkinson’s Disease Society of the United Kingdom: "When Will There Be a Cure for Parkinson's?"
Parkinson's Foundation: "Anticholinergic Drugs," "COMT Inhibitors," "Dopamine Agonists." "Levodopa," "MAO-B Inhibitors."
Purinergic Signal: "The belated US FDA approval of the adenosine A2A receptor antagonist istradefylline for treatment of Parkinson's disease."
Top What Are the Newest Drugs for Parkinson’s Related Articles
benztropineBenztropine is a medication used as an adjunct therapy for the treatment of all forms of Parkinson’s disease. Common side effects of benztropine include rapid heart rate (tachycardia), confusion, disorientation, depression, memory impairment, nervousness, visual hallucinations, worsening of psychotic symptoms, toxic psychosis, lethargy, numbness of fingers, absence of sweating (anhidrosis), high body temperature (hyperthermia), and others. Safety of use in pregnancy is not established, avoid use. Anticholinergic medications may suppress lactation and it is not known if it is excreted in breast milk, avoid use.
bromocriptineBromocriptine is a medication used to treat hyperprolactinemia, a condition with high blood levels of the hormone prolactin, and associated disorders. It is also used to treat Parkinson’s disease, excessive growth or gigantism (acromegaly), and type 2 diabetes mellitus. Common side effects of Cycloset include nausea, headache, dizziness, nasal inflammation (rhinitis), weakness (asthenia), fatigue, constipation, diarrhea, indigestion (dyspepsia), and others. Common side effects of Parlodel include nausea, headache, dizziness, constipation, diarrhea, vomiting, abdominal cramps and discomfort, loss of appetite (anorexia), indigestion (dyspepsia), gastrointestinal bleeding, and others. Cycloset must be used in pregnancy only if clearly needed. The safety of Parlodel use in pregnancy is not established. Bromocriptine should not be used in nursing mothers.
carbidopaCarbidopa is a medication always used in combination with levodopa used to treat Parkinson’s disease, a degenerative movement disorder. Common side effects with levodopa or carbidopa/levodopa combination include uncontrolled movements, impairment of voluntary movement control and slowness of movement, delusions, paranoid ideation, hallucinations, confusion, agitation, drowsiness (somnolence), dream abnormalities, nightmares, insomnia, and others.
carbidopa/levodopaCarbidopa/levodopa is a combination medication used to treat Parkinson’s disease in adults. Common side effects of carbidopa/levodopa include movement disorders (dyskinesia), nausea, vomiting, indigestion (dyspepsia), diarrhea, constipation, loss of appetite (anorexia), duodenal ulcer, gastrointestinal bleeding, dry mouth (xerostomia), taste disorder (dysgeusia), dark saliva, palpitations, cardiac irregularities, low blood pressure (hypotension), and others.
edaravoneEdaravone is a medication used to treat amyotrophic lateral sclerosis (ALS). Edaravone is a neuroprotective drug that slows down the progression of the disease and the decline in muscle function in ALS patients. Common side effects of edaravone include contusion, gait disturbance, headache, respiratory disorder, respiratory failure, low tissue oxygen saturation (hypoxia), eczema, dermatitis, tinea infection, glucose in urine (glycosuria), fatigue, hypersensitivity reactions, and anaphylaxis. Edaravone may cause fetal harm if administered during pregnancy.
entacaponeEntacapone is a prescription medication used together with carbidopa and levodopa to treat “wearing-off” symptoms of Parkinson's disease, such as stiffness, tremors, muscle spasms, and poor muscle control. Common side effects of entacapone include dizziness, drowsiness, nausea, vomiting, stomach pain, diarrhea, dry mouth, or uncontrolled muscle movements. Avoid drinking alcohol due to risk of increased side effects. Consult your doctor if pregnant or breastfeeding.
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