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Treating Parkinson's disease

Thanks to treatment advances, people with Parkinson's disease are living better for longer than ever before.

Ever since Parkinson's disease was first described in 1817, doctors and scientists have sought ways to control the tremors, stiffness, slowness of movement and impaired balance it causes.

Today's Parkinson's treatments offer better results, with fewer side effects, than ever before.

The effects of Parkinson's

Parkinson's disease damages or destroys nerve cells in a region of the brain called the substantia nigra. These cells normally produce dopamine, a chemical that's essential for controlling movement.

As more of these cells stop working, the brain's dopamine supply gets smaller. This leaves a person with decreasing control over his or her movements, causing symptoms such as tremors and trembling, stiffness in the limbs and torso, slowness of movement, and problems with balance and coordination.

The disease may also cause:

  • Depression.
  • Emotional changes.
  • Difficulty chewing, swallowing or speaking.
  • Skin problems.
  • Constipation.
  • Urinary incontinence.

Parkinson's disease cannot be cured. However, treatment can dramatically relieve symptoms, according to the National Institute of Neurological Disorders and Stroke (NINDS).

Medications

According to the NINDS, the most frequently used treatment for Parkinson's disease is the medication levodopa. The body converts this simple chemical into dopamine, helping to relieve the brain's shortage.

Levodopa may be taken alone or in combination with other drugs. These other drugs may also be taken alone. They include:

  • Amantadine, a medicine originally developed to treat viral infections. It also helps to reduce Parkinson's symptoms such as tremors and difficulty with movement.
  • Carbidopa, which delays the breakdown of levodopa until it reaches the brain. This prevents or reduces some side effects of levodopa. People taking carbidopa also don't need to take as much levodopa.
  • Dopamine agonists, which mimic dopamine's action in the brain.
  • Selegiline, which preserves dopamine in the brain by getting in the way of an enzyme that usually breaks it down.
  • Anticholinergics, which block the action of the brain chemical acetylcholine. This can help reduce tremors and muscle rigidity.
  • COMT inhibitors, which block the action of enzymes that break down levodopa before it reaches the brain.

Research continues on how to best use these drugs to delay and lessen the symptoms of Parkinson's and on new ways to deliver dopamine to the brain.

Surgery

Surgery for Parkinson's disease was more common before researchers discovered effective medications. Now surgery is usually reserved for people who don't get good results from medication.

Some surgeries destroy brain tissue that is producing Parkinson's symptoms using an extremely cold substance, liquid nitrogen.

Another procedure, deep brain stimulation, uses tiny electric jolts to interfere with activity in the area of the brain that's causing symptoms.

Other treatments

Physical therapy, occupational therapy, exercise, good nutrition, education, support groups and counseling can all help people with Parkinson's disease.

These treatments help manage the effects of the disease, allowing people to live productive lives for a longer time.

Individual needs

Parkinson's disease affects each person differently—while one person may have the most trouble with tremors, for another the major problem could be stiffness. The disease also progresses at different rates in different people.

People's responses to treatment also vary greatly—a drug combination that works well for one person may be less effective or produce lots of side effects in another.

The best treatment for any one person depends on these and other factors. An experienced doctor can help people with Parkinson's and their families find a treatment plan that works.

Learn more about the disease at the Parkinson's Foundation website, parkinson.org.

Reviewed 5/24/2021

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