At present, there is no cure for Parkinson’s disease. The goal of treatment is to keep symptoms under control for as long as possible.
The most powerful medicine to control Parkinson’s disease is levodopa, which converts into dopamine in your brain. Because levodopa causes unpleasant side effects, such as nausea and vomiting, it is almost always given in combination with carbidopa, which helps levodopa get to your brain, so that patients can get the same effect with a smaller dose. Carbidopa/levodopa can be taken as a pill (Sinemet), as a tablet that dissolves in the mouth (Parcopa), or in other formulations.
Long-term levodopa use can cause new problems, such as dyskinesia (muscles moving on their own), or the medicine may stop working, without warning, from time to time. However, waiting too long to start treatment may put you at risk for other problems, such as injuries from falling. Talk to your doctor about the risks and benefits, and when you should start treatment.
Some treatments are taken with levodopa to help it work. These include:
- MAO-B inhibitors, such as rasagline (Azilect), to slow the breakdown of levodopa and reduce symptoms
- COMT inhibitors, such as entacapone (Comtar) to keep levodopa from wearing off too quickly
- Amantadine (Symmetrel) to prevent dyskinesia caused by levodopa. Amantadine can also be used in early treatment to reduce tremors.
Other medicines your doctor may prescribe include:
- Dopamine agonists, such as pramipexole (Mirapex) and ropinirole (Requip) to stimulate your brain as if it were receiving dopamine
- Anticholinergic medicines such as benztropine mesylate (Cogentin) to reduce tremors
- Rivastigmine (Exelon) to treat dementia
Parkinson’s disease can also be treated with a technique called deep brain stimulation, in which a surgeon implants a device like a pacemaker, called an impulse generator, under your collarbone. You can use a controller to send an electric impulse from the impulse generator to the part of your brain that controls motion. This electric impulse can help:
- Problems with medication wearing off
Another type of surgery may attempt to remove or destroy the brain tissue that causes Parkinson’s disease. Scientists are also studying newer techniques involving stem cell transplants for Parkinson’s disease.