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Understanding Parkinson's Disease -- Diagnosis and Treatment

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Conventional Medicine for Parkinson's Disease continued...

Stalevo is a combination tablet that combines carbidopa/levodopa with entacapone. While carbidopa reduces the side effects of levodopa, entacapone extends the time levodopa is active in the brain.

MAO-B inhibitors also block the action of an enzyme that breaks down dopamine. They may be taken alone early in Parkinson's disease or with other drugs as the disease progresses. MAO-B inhibitors include selegiline (Eldepryl) and rasagaline (Azilect). They are usually used alone, because combining them with other drugs can cause unwanted side effects.

Dopamine agonists are dopamine-like drugs that directly imitate dopamine's activity in the brain. Pramipexole (Mirapex), rotigotine (Neuropro), and ropinirole (Requip) used alone or in combination with L-dopa treat the motor symptoms of Parkinson's disease.

Other medications prescribed for Parkinson's disease include apomorphine, benztropine, amantadine, selegiline, and anticholinergic drugs; all can help control various symptoms -- in some cases by releasing dopamine from nerve cells, in others by reducing the effects of acetylcholine, a neurotransmitter that can cause a drop in dopamine.

Other Types of Treatment for Parkinson’s Disease

Neurologists and neurosurgeons have explored various ways of grafting dopamine-producing cells in the brain of those with Parkinson’s disease, rather than trying to correct the neurotransmitter imbalance with drugs. There is research using stem cells for this purpose. 

Another surgical technique creates lesions in the globus pallidus or thalamus. These are the parts of the brain involved in Parkinson's disease. This was successful for many years but has mostly been replaced by deep brain stimulation (DBS). In this procedure, a wire is placed deep inside the brain in a specific location depending on the symptoms that need to be treated. DBS can provide dramatic improvements in many people.  

Scientists are also investigating the use of glial cell-derived nerve growth factor to treat Parkinson's and other neurodegenerative diseases. This substance is produced naturally by tissues throughout the body. Some experiments indicate that injections of this nerve growth factor may help preserve and even restore nerve cells in the brain and spinal cord -- specifically those that produce dopamine and that help initiate muscle movement. Time will tell if this and other research will be beneficial.

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