The Parkinson’s Protocol™ By Jodi KnappThus, the eBook, The Parkinson’s Protocol, educates you regarding the natural and simple ways to minimize the symptoms and delay the development of Parkinson’s effectively and quickly. It will also help your body to repair itself without following a specific diet plan, using costly ingredients or specific equipment. Its 60 days guarantee to return your money allows you to try for once without any risk.
What are the most common medications prescribed for Parkinson’s disease?
The most common medications used to manage Parkinson’s disease are designed to manage symptoms, particularly those related to motor control such as tremors, rigidity, and bradykinesia (slowness of movement). The following are the main categories of medications typically prescribed:
1. Levodopa (L-DOPA)
Levodopa is the most common medication used for Parkinson’s disease. Levodopa is metabolized to dopamine in the brain, helping to replace the missing dopamine due to the loss of dopaminergic neurons.
Carbidopa is typically coadministered with levodopa in medications like Sinemet or Rytary to prevent the breakdown of levodopa before it reaches the brain.
Side Effects: Long-term use can result in motor fluctuations, including dyskinesias (movements) and wearing-off effects of the drug (when the drug effect wears off before the next dose).
2. Dopamine Agonists
These medications substitute the action of dopamine by stimulating the dopamine receptors in the brain. They are typically used in early Parkinson’s disease or as add-on therapy to levodopa.
Some of the popular dopamine agonists are:
Pramipexole (Mirapex)
Ropinirole (Requip)
Rotigotine (Neupro) – patch form
Apomorphine (Apokyn) – for sudden relief of severe symptoms, often administered by injection.
Side Effects: Dopamine agonists can cause hallucinations, drowsiness, impulse control disorders (compulsive gambling or eating), and swelling.
3. Monoamine Oxidase B (MAO-B) Inhibitors
These drugs inhibit the activity of the enzyme monoamine oxidase B, which breaks down dopamine in the brain, so that there is more dopamine available. They are used typically at the onset of the disease or added to levodopa.
Common MAO-B inhibitors include:
Selegiline (Eldepryl, Zelapar)
Rasagiline (Azilect)
Safinamide (Xadago)
Side Effects: MAO-B inhibitors can cause nausea, headache, and insomnia. They must be used cautiously with certain drugs and foods containing tyramine (such as aged cheese), because it can result in high blood pressure.
4. Catechol-O-Methyltransferase (COMT) Inhibitors
These drugs help prolong the effect of levodopa by blocking the action of the enzyme COMT, which breaks down dopamine. They are typically taken with levodopa to smooth out the “wearing off” and reduce fluctuations.
Some of the common COMT inhibitors are:
Entacapone (Comtan)
Tolcapone (Tasmar)
Side Effects: Side effects are diarrhea, liver impairment (especially with tolcapone), and enhanced dyskinesia when combined with levodopa.
5. Anticholinergics
These medications suppress tremor and rigidity by blocking the action of acetylcholine, a neurotransmitter activated by low levels of dopamine.
Anticholinergic drugs most often employed are:
Benztropine (Cogentin)
Trihexyphenidyl (Artane)
Side Effects: These include dry mouth, constipation, blurred vision, confusion, and retention of urine. They are not usually employed in elderly due to their psychic side effects.
6. Amantadine
Initially developed as an antiviral, amantadine also has the property of reducing dyskinesias (involuntary movements) due to long-term use of levodopa. It is also used during the early course of Parkinson’s disease to alleviate motor symptoms.
Side Effects: Side effects include nausea, dizziness, insomnia, and edema of the lower extremities. In some patients, it can cause livedo reticularis, which is a lacy rash on the skin.
7. Deep Brain Stimulation (DBS)
While not a medication, deep brain stimulation is a surgical procedure in which an implanted device sends electrical impulses to specific parts of the brain to help manage motor symptoms. It’s usually reserved for patients with advanced Parkinson’s disease with motor fluctuations or dyskinesias despite optimal medication.
8. Other Medications and Treatments
Duopa: A gel drug combination of carbidopa and levodopa delivered continuously via a pump in advanced Parkinson’s disease.
Istradefylline (Nourianz): A new medication introduced that functions as an adenosine A2A receptor antagonist, which has the potential to improve motor function when added to treatment with levodopa.
Conclusion
The treatment of Parkinson’s disease is typically a combination of drugs specific to symptom control, notably motor symptoms of rigidity, tremor, and bradykinesia. Levodopa remains the cornerstone of therapy, at times combined with other medications like dopamine agonists, MAO-B inhibitors, or COMT inhibitors. Control of side effects and adjustment of drugs as the disease progresses are vital to improve the quality of life of patients with Parkinson’s disease.
Dopamine agonist therapy is an important therapy for Parkinson’s disease (PD), particularly in the management of symptoms such as tremor, rigidity, and bradykinesia (slowness). The following is how dopamine agonists work in Parkinson treatment:
1. What Are Dopamine Agonists?
Dopamine agonists are drugs that mimic dopamine, a neurotransmitter that is deficient in the brains of people with Parkinson’s disease. In PD, the loss of brain cells that make dopamine, particularly in the substantia nigra, leads to motor signs such as tremor, stiffness, and difficulty with movement.
Dopamine agonists do not replace dopamine itself. Instead, they work by binding with dopamine receptors in the brain and stimulating them and mimicking the actions of dopamine, thereby enhancing the motor symptoms.
2. Mechanism of Action
Activation of Dopamine Receptors: Dopamine agonists stimulate dopamine receptors (D2 receptors) in the basal ganglia of the brain, a key controller of movement. By stimulating these receptors, dopamine agonists restore balance to the movement system and relieve symptoms like rigidity and tremor.
No Production of Dopamine Required: As opposed to medications that aim to stimulate dopamine production (e.g., levodopa), dopamine agonists bind directly to the receptors. This is helpful, especially in the earlier stages of Parkinson’s since the neurons producing dopamine are still functional to a certain extent.
3. Benefits of Dopamine Agonists in Parkinson’s Disease
Relief of Motor Symptoms: Dopamine agonists facilitate relief of core motor symptoms of Parkinson’s disease, including tremor, rigidity, and bradykinesia. This relief takes place because the agonists imitate the actions of dopamine on the brain.
Delays the Need for Levodopa: Levodopa is the best treatment for symptoms of Parkinson’s disease but can eventually become less effective and lead to such complications as motor fluctuations (e.g., “wearing-off” effects). Dopamine agonists may be used in early Parkinson’s to delay or reduce the need for levodopa.
Improved Quality of Life: Patients frequently experience an improvement in their quality of life because dopamine agonists can manage motor symptoms and potentially reduce the frequency of levodopa dosing.
4. Dopamine Agonist Types
There are several dopamine agonists that have been approved for Parkinson’s disease treatment, including:
Pramipexole (Mirapex)
Ropinirole (Requip)
Rotigotine (Neupro)
Apomorphine (Apokyn) – typically reserved for acute, intermittent treatment of motor fluctuations.
Bromocriptine (Parlodel) – used less often due to side effects but still an option in certain situations.
5. When Are Dopamine Agonists Prescribed?
Early-Stage Parkinson’s: Dopamine agonists may be prescribed early in the course of Parkinson’s disease, as a first-line drug in most patients. Dopamine agonists can manage symptoms without the risk of motor fluctuations that occurs with long-term levodopa treatment.
In Combination with Levodopa: In more advanced disease, the dopamine agonists may be combined with levodopa to gain better symptom control, especially in cases where the patient has “wearing-off” effects or is unable to tolerate large doses of levodopa.
As Add-on Therapy: For patients with significant motor fluctuations on levodopa, dopamine agonists can be added to the treatment to enhance the control of symptoms.
6. Side Effects of Dopamine Agonists
Although dopamine agonists are effective in managing Parkinson’s symptoms, they also possess side effects. The most common side effects are:
Nausea and Vomiting: They are two of the most common side effects, especially during the initial treatment. It can be managed by starting treatment with low doses and gradually increasing them.
Somnolence and Drowsiness: Severe somnolence, daytime drowsiness, or sudden onset of sleep (a rare but risky side effect) can be caused by dopamine agonists.
Hallucinations and Psychosis: Visual and auditory hallucinations, confusion, or other psychotic features can be seen in some patients. This is more common in elderly patients or patients with severe Parkinson’s disease.
Impulse Control Disorders: Some behavioral changes such as gambling, spending money excessively, or excessive sex may be seen in certain individuals with the use of dopamine agonists. This action, also known as impulse control disorders, is an accepted side effect.
Orthostatic Hypotension: Blood pressure fall during standing up and causing dizziness or fainting is a possible side effect.
Edema: Swelling of legs or ankles is possible.
7. Advantages and Limitations
Advantages:
Reduced Levodopa Dependence: By enabling symptomatic relief without having to totally depend on levodopa, dopamine agonists postpone the eventual use of levodopa and shorten long-term risks of levodopa.
Better Symptom Control: Dopamine agonists are capable of providing longer-duration control of Parkinson’s symptoms throughout a regular day, particularly when combined with levodopa.
Potential for More Sustained Benefits: Because dopamine agonists have a longer half-life than levodopa, they have the potential to extend the time of symptom control.
Limitations:
Side Effects: The risk of side effects like nausea, sleepiness, and impulse control disorders can be problematic, and patients may require close monitoring.
Less Effective Than Levodopa: While dopamine agonists manage symptoms, they are not as effective as levodopa. As the disease progresses, dopamine agonists are less effective, and levodopa can be needed to manage symptoms more effectively.
8. Monitoring and Adjusting Treatment
Dopamine agonists require routine follow-up evaluations for side effects, efficacy, and overall disease course in patients taking them. Dosage modification or treatment adjustment may become necessary to maximize symptom control.
Conclusion
Treatment with a dopamine agonist is the focal point of treating Parkinson’s disease, offering advantage in terms of symptom relief and postponement of levodopa need. Adverse effects, however, should be closely followed. Dopamine agonists bring a remarkable alteration in the patient’s quality of life when appropriately used, most notably at disease onset or as an add-on treatment in late disease.
The Parkinson’s Protocol™ By Jodi KnappThus, the eBook, The Parkinson’s Protocol, educates you regarding the natural and simple ways to minimize the symptoms and delay the development of Parkinson’s effectively and quickly. It will also help your body to repair itself without following a specific diet plan, using costly ingredients or specific equipment. Its 60 days guarantee to return your money allows you to try for once without any risk