- Parkinson's Clinic INT
MEDICATIONS FOR PARKINSON’S DISEASE
At this time there is no treatment that has been shown to cure this dreaded disease. Mainstream medicine claims that the current medications do help with symptoms for some people and are no help at all for many others. They also state that no prescription has been shown to slow or stop the progression of this illness.
It has been recognized for decades that providing the body with more dopamine is the “Gold Standard” for managing the symptoms associated with PD.
Following is a review of the major prescription medications along with their side effects.
Carbidopa/levodopa Levodopa is the major medication for PD management of symptoms. It supplies the brain with dopamine that is sorely lacking due to damage in the dopamine sensitive areas. Levodopa is a precursor of dopamine and unlike dopamine itself, it can pass through the blood-brain barrier where it is converted to dopamine. Sinemet (carbidopa/levodopa) has been shown to manage some of the symptoms while it does not stop the progression. In mega studies, it has been shown to shorten the life span of PD victims by 6 to 8 years. Carbidopa/levodopa is challenging to regulate to appropriate level of dopamine in that each person requires a specific amount of l-dopa to successfully manage the highest number of symptoms. There currently is no way to customize the dosage for maximum benefit.
The most common side effects of levodopa are NAUSEA, ORTHOSTATIC HYPOTENSION (low blood pressure leading to dizziness), VIVID DREAMS, AND HALLUCINATIONS. The motor side effects are thee dramatic variations in motor ability. There are the famous “on” and “off” periods so frequently associated with PD. As the disease progresses, the dosage must be increased as goes the amount and the frequency of dosing.
Chronic use of levodopa may lead to dyskinesias. This can look like involuntary jerking movements that the PD person can not control. Dystonia can also be a new symptom that occurs with chronic use of levodopa. Here abnormal fixed posturing (especially in the foot) can cause pain in instability when walking or standing. This usually occurs as levodopa is wearing off.
Levodopa is the most effective treatment for managing the symptoms of PD. Initially, levodopa was administered alone and many people experienced nausea and vomiting. Levodopa is almost always given with carbidopa which helps manage the nausea. The carbidopa degrades vitamin B6 which over time leads to the need for more and more levodopa. In Europe and other parts of the world, Benserazide is used instead of Carbidopa.
Dopamine agonists These include Ropinirole, Pramipexole, and Rotiogotine. These are artificial molecules which mimic dopamine. They bind to dopamine receptors and directly replace dopamine. These medications are significantly less effective that levodopa and are sometimes used along with levodopa. These medications have more side effects that levodopa.
Anticholinergics and Amantadine are currently less frequently prescribed do to there side effects.