Parkinson's Disease

There is no cure for Parkinson’s disease, but medications can help control the symptoms. In some cases, doctors may recommend surgery. Other therapies and counseling may help ease and deal with symptoms.

Treatments for Parkinson’s disease include:

Medication

Medication treatments can help control Parkinson’s disease symptoms and cope with the condition. These include:

• Carbidopa-Levodopa. Also called L-DOPA, this medicine converts to dopamine in the brain and is the most effective medication for Parkinson’s disease. Carbidopa is combined with levodopa to prevent its breakdown before it reaches the brain. The effect of levodopa may decrease over time.
• Amantadine. This may be prescribed in the early stage of Parkinson’s disease to help with mild symptoms. It may also be given with carbidopa-levodopa therapy during the later stages of Parkinson’s disease to control involuntary movements (dyskinesia) caused by carbidopa-levodopa.
• Catechol O-methyltransferase (COMT) inhibitors. These drugs are sometimes prescribed with levodopa to extend its effect.
• Dopamine agonists. These medicines imitate dopamine effects in the brain. They are less effective than levodopa and are sometimes used in tandem with levodopa.
• Monoamine oxidase (MAO-B inhibitors). Doctors may prescribe these to help prevent the breakdown of dopamine in the brain.
• Adenosine (A2A) receptor antagonists. These drugs can help reduce the number of levodopa doses needed and ease levodopa’s side effects.
• Anticholinergics. This kind of medicine helps control the tremor symptom of Parkinson’s disease.
• Nuplazid. This is an atypical antipsychotic used to treat hallucination and delusion symptoms that might be associated with Parkinson’s disease.
• Antidepressant medications. Antidepressants may be prescribed to help ease the symptoms of depression associated with having a chronic disease, including Parkinson’s.

Surgical treatment

• Deep brain stimulation (DBS). Patients may be candidates for DBS once the disease advances. It is not a cure for Parkinson’s disease and does not slow its progression, but it can reduce symptoms and improve the quality of life of people with Parkinson’s disease.
  
  With DBS, the neurosurgeon implants electrodes in a specific part of the brain. The electrodes are connected to a device that is implanted in the patient’s chest and sends electrical pulses to the brain to reduce symptoms. Specifically, DBS can help reduce involuntary movements (dyskinesia), reduce tremors and rigidity, and improve movements.
• Focused ultrasound. A minimally invasive MRI-guided procedure may be an option to treat tremors in people with Parkinson’s disease. This is performed using an MRI scanner that allows the surgeon to target specific brain cells with minimal harm to surrounding tissue and minimal side effects.

Therapy and counseling

• Therapies. Physical, occupational, speech, and nutritional therapies can help people with Parkinson’s disease maintain function. Services include:
  • Physical therapy – A physical therapist can develop an activity plan to help maintain physical function based on muscle strength and motor skills.
  • Speech therapy – Speech therapy can help improve or maintain the clarity and volume of a patient’s speech. A specialist can teach safe swallowing techniques.
  • Occupational therapy – An occupational therapist can help patients organize their homes to ensure safety, and can recommend equipment such as canes, walkers, wheelchairs, neck supports, and more to help with mobility and safety.
  • Dietician – A dietician can help develop a personalized eating plan that meets the patient’s needs and preferences.
• Counseling and support. People with Parkinson’s disease may feel frustrated, angry, and depressed. Counseling and support groups can help people find ways to cope with the situation and better manage frustration, depression, and anxiety.
  • Counseling – People with Parkinson’s disease and their families can benefit from talking to a mental health provider, such as a psychologist or a social worker with experience in chronic conditions. These professionals can help patients cope with depression and other mental conditions associated with having a chronic disease.
  • Support groups – A support group can be a good resource for people with Parkinson’s, as well as their families, to find practical information about the disease. Support groups can also provide general support and comfort. A social worker or therapist can recommend appropriate groups in the patient’s community, as well as other resources and organizations.
• Other therapies and practices – In addition to medications and therapies, some practices and supportive therapies can help ease pain, fatigue, depression, and possibly other symptoms of Parkinson’s disease. These include:
  • Tai chi – This Chinese martial art is characterized by slow, flowing motions that may improve flexibility, balance, and muscle strength. Tai chi may help improve or maintain balance in people with mild to moderate Parkinson’s disease.
  • Yoga – Gentle stretching movements and poses may increase flexibility and balance. Poses can be modified to fit different physical abilities.
  • Alexander technique – Focusing on muscle posture and balance, this educational method teaches people to be more aware of their bodies in order to reduce muscle tension and pain.
  • Massage therapy – Massage can reduce muscle tension and promote relaxation.
  • Meditation and relaxation techniques– Certain mindfulness and relaxation techniques may reduce stress and pain, and can promote a sense of well-being.
  • Pet therapy – Being around a dog or cat may improve patients’ emotional health.