Drug Treatment for Parkinson's Disease
Dopamine agonists are drugs that activate the dopamine receptor. They mimic or copy the function of dopamine in the brain.
Requip (ropinirole), Mirapex (pramipexole), and Neupro (rotigotine) are dopamine agonists. These medications may be taken alone or in combination with Sinemet. Generally, dopamine agonists are prescribed first and levodopa is added if the patient's symptoms cannot be controlled sufficiently.
Because dopamine agonists are better tolerated and do not have the same risks of long-term complications as levodopa therapy, dopamine agonists are often the first choice of treatment for Parkinson's disease.
However, dopamine agonists do carry a risk of short-term side effects such as nausea, vomiting, dizziness, light-headedness, confusion, and hallucinations.
Symmetrel (Amantadine) may be a helpful treatment for people with mild Parkinson's disease, but it may cause side effects including confusion and memory problems. Symmetrel increases the amount of dopamine available for use in the brain, therefore reducing symptoms of Parkinson's. There have been recent reports that Symmetrel may help reduce the involuntary movements (dyskinesia) associated with levodopa therapy.
Anticholinergics (Artane, Cogentin)
Anticholinergics are used to restore the balance between the two brain chemicals, dopamine and acetylcholine, by reducing the amount of acetylcholine. This acts to reduce tremor and muscle stiffness in people with Parkinson's. These medications, however, can impair memory and thinking, especially in older people; therefore, they are rarely used today.
Eldepryl and Azilect
(rasagiline) work by helping to conserve the amount of dopamine available by preventing the dopamine from being destroyed. While controversial, there is some evidence that Eldepryl may slow the progression of Parkinson's disease, particularly early in the course of the disease. Eldepryl is well-tolerated by most people, so many experts recommend using it. Common side effects include nausea, dizziness/fainting, and stomach pain.
Azilect is taken once daily and can be taken alone early in the disease or with other Parkinson's drugs as the disease progresses. Early animal studies suggest Azilect may also slow progression of Parkinson's. Side effects include headache, joint pain, indigestion, and depression.
Tasmar, Comtan (COMT Inhibitors)
When COMT is blocked, dopamine can be retained and used more effectively, reducing Parkinson's symptoms. COMT inhibitors like Tasmar (tolcapone) and Comtan (entacapone) can also increase the effectiveness of levodopa.