Non-oral Therapies

When movement symptoms become more complex, non-oral 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. These treatments include Apomorphine injections, Apomorphine pump therapy, Duodopa® pump therapy 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.

Any patient who is being considered for any of the non-oral therapies will be referred into the nurse-led non-oral clinic at UHCW for further assessment to discuss these in more detail.

Apomorphine

Apomorphine is an injectable dopamine agonist that can be administered via an injector pen or an infusion pump directly into the skin. This drug is considered for some patients to help improve the periods of ‘off’ time (time spent in an immobile state). If you are suitable for this type of treatment, your consultant or Parkinson’s disease nurse specialist will discuss this option with you in your outpatient appointments.

There are two brands which we currently use:

1) Britannia (APO-go) via an APO-go pen or pump infusion. For more information please click here.
2) EVER PHARMA (Dacepton) via a D-mine pen or pump infusion. For more information please click here.

Deep Brain Stimulation

Deep brain stimulation (DBS) is considered for some people where medication is not adequately managing certain motor symptoms, including slowness (bradykinesia), tremor, or uncontrolled movements (dyskinesias).

DBS involves the implantation of fine wires into the part of the brain affected by Parkinson’s disease. These are then connected to a battery, which will then send a constant electrical signal to the wire to help reduce some of the motor symptoms mentioned above. If you are suitable for this treatment, your consultant will refer you to a specialist Neurosurgical centre.

Duodopa

Duodopa is a non-oral therapy used in Parkinson’s disease. It is a gel form of levodopa (co-careldopa) medication, which is suitable for a small number of people whose symptoms cannot be controlled with oral drug treatments. Duodopa can help reduce involuntary movements (dyskinesia), immobile “off” periods and motor fluctuations. It is administered via a pump connected to PEJ tube that is surgically inserted into the intestine. UHCW is one of 22 designated specialist Neuroscience centres in England that is able to initiate, monitor and support people who are considered for this treatment.

For further information please click here.

Updated 22 November 2021