Drug treatments in Parkinson's

To improve the movement difficulties caused by Parkinson’s, drug treatments aim to increase the level of dopamine that reaches the brain and/or to stimulate the parts of the brain where dopamine works. Different drug regimes may be used for different people depending on the particular symptoms at the time. Please note that the following information is only a very brief guide and is by no means exhaustive. Treatment options will be discussed with you individually by your Consultant or Parkinson's Nurse Specialist.

All the treatments mentioned below for Parkinson’s can be provided by the Coventry & Warwickshire Service, including Apomorphine and Duodopa, with the exception of Neurosurgery for Parkinson’s, for which we refer patients to our colleagues in Birmingham or Oxford.

Dopaminergic drug treatments in PD

There are four main classes of dopaminergic drug that can be used: levodopa, dopamine agonists, COMT inhibitors and MAO-B inhibitors. The table below lists some of the drugs you may be given.

It is very important to try and take these medicines at the times suggested by your doctor and not to miss any doses. If you are admitted to hospital for any reason make sure you tell the staff treating you exactly what brand and dose of levodopa you are taking and the times you take it.

Dopamine agonists (and occasionally levodopa) are sometimes associated with Impulse Control Disorders. Impulsive behaviour is when a person cannot resist the temptation to carry out certain activities that could lead them to harm themselves or others. In many cases, this behaviour is out of character. This behaviour can be expressed in a number of different ways, including: addictive gambling, impulsive shopping, binge eating or hypersexuality (a preoccupation with sexual feelings and thoughts).

If you are started on dopaminergic medications you will be monitored closely for any sign of an impulse control disorder. If you think you may be developing an impulse control disorder please contact your Parkinson’s nurse specialist, consultant or GP. Do not stop taking your medication without advice. Impulse control disorders are treatable but you may need to decrease the amount of medication you are on or change to a different drug.

Treatments for non-motor symptoms

There are many symptoms that might occur if you have Parkinson’s and the symptoms not related directly to movement are called the ‘non-motor’ symptoms. These can include constipation, urinary symptoms, sleep disturbance, memory problems, depression, anxiety, pain, drooling and blood pressure dropping on standing (known as postural hypotension). It is important to let your Parkinson’s specialists know if you have any troublesome symptoms (you will be asked about them in Parkinson’s clinics) as they are very often treatable.

Treatments for more complex Parkinson’s symptoms

Several other treatments may be considered at some point, depending on your symptoms. Your Parkinson's consultant or nurse will discuss these in more detail if relevant. Other treatments can include Amantadine tablets, Apomorphine injections, Apomorphine pump therapy, Duodopa® pump therapy (levodopa given via a feeding tube into the small bowel) and Neurosurgery (Deep Brain Stimulation).

If you come across any treatment that you think might be relevant to your Parkinson’s, please feel free to discuss it with your Parkinson’s nurse or consultant.

Updated  30 January 2018

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