Medicines

 

Medicines used for Parkinson disease

 

The medication most commonly used is a combination drug called Levodopa/Carbidopa, in most

people this combination improves mobility and allows them to function relatively normally.  One problem is that as the disease progresses increased doses have to be taken to manage the symptoms as they progress.  This is widely recognized as the most effective treatment for the motor symptoms.

 

 

Pros for the use of Levodopa/Carbidopa are:

 

         1. Improves mobility

 

         2. Most effective

 

Cons and complications are:

 

         1. Has not been shown to slow the disease process.

 

         2. Significant side affects such as:  dyskinesia (involuntary movements and tics),

hallucinations and illusions.

 

         3. High protein diets may in inhibit the drugs absorption.

 

         4. Not affective at treating all symptoms such as, posture, depression and cognitive problems.

There is a group of medicines that are called Dopamine Agonists, these medicines mock the effect that dopamine has in your brain. They can be use alone or with Levodopa/Carbidopa. Some of these medicines are: Ropinerole, pramipexole, and bromocriptine. Some of these medicines are newer than others.

 

Pros for the use of these drugs are as follows:

 

1. They are less likely to cause motor fluctuation,including dyskinesia

     2.  High protein diets do not affect them

 

     3.  Come can be used as a patch which is an advantage over oral administration

 

Cons and complications

 

1. They have not been shown to slow down the disease

     2.  They are not as effective as Levodopa/Carbidopa

 

     3.   Not effective in treating all the symptoms

 

     4.   They may have other side effects such as, daytime sleepiness, hallucinations, sleep attacks

 

(sudden unanticipated sleep), and risk taking behavior, such as sexual obsessions and gambling

 

 

Another group of medicines are MAO- inhibitors. These are Selegiline and Rasagiline.  They stop an

 

enzyme from breaking down the Levodopa.  These drugs can also be used alone or with

 

Levodopa/Carbidopa.

 

Pros for these drugs are as follows:

1. They can prolong the action of Levodopa

     2.  May have mild antidepressant effect

 

     3.   They may offer some neuroprotection (research is ongoing

 

Cons and complications

1. Small benefits with symptoms of Parkinson's

     2.  They may have interactions with other drugs and foods such as:

 

          a. You must measure your blood pressure carefully

 

          b. They have potential interactions with antidepressants

 

          c. Selegiline causes more problems with the elderly

 

The last group I will cover is called COMT (Catechol O-methyltransferase)- inhibitors.  These are

 

Entacapone and Tolcapone.  These drugs help larger amounts of Levodopa reach the brain.  They help

 

provide a more stable, constant supply of Levodopa.

 

Pros are as follows:

• Can prolong the action of Levodopa

Cons and complications

• They may increase side effects associated with Levodopa such as dyskinesia and hallucinations

• Tolcapone has been known to cause liver problems in patients