Parkinson's Disease Treatments

While a cure for Parkinson’s disease (PD) has not yet been found, thanks to research conducted in recent decades, many treatments are available to help manage the condition. And because Parkinson's disease is a progressive disease, it’s crucial to begin treatment as soon as possible. Working together, you and your medical team will select the best treatment approach for you based on your symptoms and needs. Parkinson’s disease treatment options include:

• Medications
• Surgical treatment
• Clinical trials

Medications to Treat the Symptoms of Parkinson's Disease

There are a number of different kinds of medications available to treat the symptoms of Parkinson's disease. Most medications for Parkinson's disease treat dopamine deficiency by either helping to replace dopamine, preventing its breakdown, or mimicking its effects.

• Levodopa: medication that helps replace dopamine

  Levodopa is a drug the body can convert into dopamine and is one of the most effective treatments for the symptoms of Parkinson's disease. However, as the disease advances, levodopa’s benefit becomes less predictable. The risk of complications, such as motor fluctuations and dyskinesias (involuntary movements), increases. This is why it has become common practice to look at other medications to use as individual therapies or in conjunction with levodopa. In some cases, the choice may be made to delay using levodopa in order to prolong its effectiveness in later stages of Parkinson's disease - especially in younger patients. 

• Enzyme inhibitors: medications that help prevent the breakdown of dopamine

  These medications target specific enzymes that regulate the levels of dopamine in the body. They may 1) stop the enzymes that break down levodopa (a drug the body can convert to dopamine); or 2) stop the enzymes that destroy dopamine.  Examples of enzyme inhibitors include carbidopa, catechol-O-methyltransferase (COMT) enzyme inhibitors, and monoamine oxidase-B (MAO-B) enzyme inhibitors.

• MAO-B inhibitors

  These block the actions of the MAO enzyme, type B, which is responsible for the majority of the breakdown of dopamine in the brain. When used as initial therapy to treat early symptoms of Parkinson's disease, MAO-B inhibitors help control motor symptoms and may delay the need for levodopa therapy. When prescribed along with levodopa, MAO-B inhibitors have also been shown to reduce “off” time.

• Dopamine agonists (DAs): medications that mimic the effects of dopamine

  DAs work by attaching to dopamine receptor sites in the brain and mimicking the effects of dopamine. DAs may be used alone or in combination with levodopa, and they may reduce the required dosage of levodopa.

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Surgical Treatment for the Symptoms of Parkinson's Disease

Deep brain stimulation (DBS) is the most common surgical procedure used to treat the symptoms of Parkinson's disease.  However, DBS is generally considered only if currently available medications are not effective or if your symptoms have progressed to the point that prescription medications no longer offer benefit.

In DBS, neurosurgeons implant an electrode into an area of the brain that affects movement. The electrode delivers a continuous high-frequency electrical stimulation, helping control the movement center in the brain. DBS frequently leads to a dramatic improvement in Parkinson's disease symptoms and may allow for a reduced dose of levodopa, which may improve levodopa-related side effects and complications. People with Parkinson's disease should always consult with a movement disorder specialist before considering this option.

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Participating in Clinical Trials

Every Parkinson’s disease treatment approved by the U.S. Food and Drug Administration (FDA) must go through extensive testing of its safety and efficacy before doctors can prescribe it. This process requires clinical research and the participation of many people diagnosed with Parkinson’s disease. Participation in a clinical trial may offer you several benefits, including:

• Taking a more active role in the management of your Parkinson’s disease
• Gaining access to experimental treatments before they are FDA approved
• Receiving quality medical care free of charge for the duration of the trial
• Helping to advance the knowledge and treatment of Parkinson’s disease by participating in medical research

• PDtrials — A comprehensive listing of clinical trials in Parkinson’s disease maintained by the Parkinson’s Disease Foundation (PDF)
• ClinicalTrials.gov — General information from the National Institutes of Health (NIH) about clinical trials

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