There is no cure for Parkinson's disease, but it can be managed -- and the symptoms of the disease can be relieved or reduced.
Treating Parkinson's disease is often a "team effort" involving not only your neurologist but also a wide variety of specialists. Your health care team should include:
- Neurologists
- Occupational therapists
- Physical therapists
- Counselors
- Social workers
- Speech therapists
- Registered dietitians
The goals of treatment vary for each person, but in most cases, treatment for Parkinson's disease is designed to:
- Maintain overall quality of life
- Improve mobility and function
- Reduce rigidity
- Reduce tremor
- Reverse slowed movements
- Improve posture, gait, balance, speech, and writing skills
- Maintain mental sharpness
What Are Some Drugs That Treat Parkinson's Disease?
Most people with Parkinson's disease can be treated using prescribed medications. The most commonly prescribed drugs include:
- Benztropine mesylate (Cogentin)
- Entacapone (Comtan)
- Istradefylline (Nourianz)
- Levodopa and carbidopa (Sinemet)
- Opicapone (Ongentys)
- Pramipexole (Mirapex)
- Rasagiline (Azilect)
- Ropinirole Hcl (Requip)
- Rotigotine (Neupro)
- Safinamide (Xadago)
- Tolcapone (Tasmar)
- Trihexphenidyl (Artane)
You and your doctor will determine the best way to successfully use medications for your Parkinson’s. There may be specific guidelines, but generally, your doctor or pharmacist may advise:
- Do not split pills or pull capsules apart unless directed by your doctor.
- Drink 6-10 glasses of water a day.
- Warm baths or physical activity may help with digestion and absorption of your medicines.
- Know the names of your medications and how they work. Know the generic and brand names, how much to take, and potential side effects. Always keep a list of your medications and their dosages with you, and exactly how you are taking them. Keep the list with you in your wallet or purse.
- Take your medications exactly as your doctor prescribes them.
- Do not stop taking or change your medicines unless you talk to your doctor first. Even if you feel well, keep taking them. Stopping your medications suddenly can cause problems.
- Do not double the dose of your medication.
- Have a routine for taking your medicines. Take them at the same time each day. Get a pillbox that is marked with the days of the week, and fill it at the beginning of the week to make it easier for you to remember.
- Keep a medicine calendar and note every time you take a dose.
- If you miss a dose at the scheduled time, don't panic. Take it as soon as you remember. But, if it is almost time for your next dose, skip the missed dose and return to your regular medication schedule. Set an alarm clock if necessary.
- Store your medicine in a dry area away from moisture (unless your doctor or pharmacist tells you the medicine needs to be refrigerated).
- Always keep all medications out of the reach of children.
- Know which side effects to expect from your medications. Contact your doctor right away if you have any unusual or unexpected side effects.
- Do not share your medications with others.
- Keep your medications in your carry-on luggage when you travel. Don’t pack your medications in a suitcase that is checked, in case the suitcase is lost.
- Take extra medicine with you when you travel in case your flight is delayed or you need to stay away longer than planned.
- Don’t wait until you are completely out of medication before filling your prescriptions. Call the pharmacy at least 48 hours before running out. If you have trouble getting to the pharmacy, have financial concerns, or have other problems that make it hard for you to get your medicine, let your doctor know. A social worker may be available to help you.
To avoid interactions with other medications, you should:
- Read all labels carefully.
- Make sure your health care providers know about all the medications you’re taking.
- Know your drug and food allergies.
- Make a list of your medications and dosages. Eye drops, vitamins, herbal supplements, and some skin products are considered medications and should be included. Keep this with you and update it if you start using something new.
- Review possible drug side effects. Most reactions will happen when you start a new drug, but not always. Some reactions may be delayed or may happen when another medication is added.
- Try to fill all your prescriptions at the same pharmacy, so the pharmacist can watch for interactions and track proper dosing and refills.
If you have a bad reaction to medications, or if the medications become ineffective, surgery may be advised.
What Are Surgery Options for Parkinson's Disease?
Depending upon your needs, medical history, health, and symptoms, one of the following procedures may be considered for Parkinson's disease:
- Deep brain stimulation
- Duopa pump
- Pallidotomy
- Thalamotomy
- Gamma knife
There are many other procedures being researched. One of the most promising involves the transplantation of fetal dopamine neurons (tissue transplant) into the brains of people with Parkinson's disease. The hope is that these cells will be able to re-grow the damaged dopamine-producing nerve cells.
Are There Clinical Trials for Parkinson’s?
A clinical trial is a research program done with patients to evaluate a new medical treatment, drug, or device. The goal is to find new and improved ways to treat diseases and conditions.
During a clinical trial, doctors use the best available treatment as a standard to evaluate new treatments. The new treatments are hoped to be at least as effective as -- or possibly more effective than -- the standard.
New treatment options are first carefully researched in the laboratory -- in the test tube and in animals. Treatments most likely to work are further evaluated in a small group of humans. Then, they may be moved to a larger clinical trial.
When a new medical treatment is studied for the first time in humans, scientists don't know exactly how it’ll work. Any new treatment has possible risks and benefits. Clinical trials help doctors find out:
- If the treatment is safe and effective
- If the treatment could be better than treatments currently available
- The side effects of the treatment
- Possible risks of the treatment
Some advantages of taking part in a clinical trial are:
- The latest scientific and technological advances can be used in patient care.
- You may get a new treatment before it is widely available to the public.
- You can help researchers get information they need to continue developing new procedures and new treatments, for your benefit and the benefit of others.
- Your treatment costs may be lower, since many of the tests and doctor visits that are directly related to the clinical trial are paid for by the company or agency sponsoring the study. Be sure to discuss your treatment costs with the doctors and nurses doing the clinical trial.
Some disadvantages of participating in a clinical trial are:
- Because the drug or device being studied is new, all of the risks and side effects of the treatment aren’t known. Patients will be informed of any known side effects, and any side effects that happen or become known during the trial.
- It is also important that you realize that if you participate in a clinical trial, you may be given a placebo. That is a sugar pill containing no medicine. These tablets are used to figure out whether the real treatment is truly working well. Trials are done in such a way that you won’t be told whether you're getting the real treatment or a "fake" treatment.
If you take part in a clinical trial, you may notice some changes in your care:
- You may get more exams and tests than usual for your Parkinson’s. That lets the researchers follow your progress and collect study data. Of course, tests can carry certain benefits and risks or discomforts. Although they can be inconvenient, these tests can ensure closer observation.
- Depending on the type of clinical trial, you may be asked to stop or change the medication(s) you are taking. You may also be asked to change your diet or any activities that could affect the outcome of the trial.
- As mentioned, you could get the placebo rather than the real medicine.
If you think you might want to take part in a clinical trial, find out as much as possible about the study before you decide. You can ask:
- What is the purpose of the clinical trial?
- What kinds of tests and treatments does the clinical trial involve?
- How are these tests done?
- How could the clinical trial affect my daily life?
- What side effects can I expect?
- How long will the clinical trial last?
- Will the clinical trial require me to give up some of my personal time? If so, how much?
- Will I have to be hospitalized? If so, how often and for how long?
- If I agree to withdraw from the clinical trial, will my care be affected? Will I need to change doctors?
- If the treatment works for me, can I continue taking it after the trial?
For information about ongoing Parkinson's disease studies, contact the National Institutes of Health.
Alternative Treatments for Parkinson's Disease
Alternative therapy may also be used to treat Parkinson's disease. The most touted in recent years has been the effect of Vitamin E on reversing the progression of the disease; although, this effect is still being debated by the scientific community.
Relaxation and guided imagery have also been suggested to help with stress, depression, and anxiety. Medical studies have shown that relaxation and guided imagery may help slow the progression of symptoms as well as quicken healing time after surgeries or injuries.