Most Effective Parkinson’s Medications

New Gene Therapy Trial To Explore Parkinsons Disease Treatment Option

MORGANTOWN, W.Va – The WVU Rockefeller Neuroscience Institute has announced the start of a clinical trial that evaluates the safety and efficacy of a new gene therapy in the treatment of Parkinsons disease.

While surgical implants used in deep brain stimulation can treat Parkinsons disease, gene therapy can be of particular benefit without the need for implants in the brain.

This new study is the next step from a previous sham-controlled study that showed promise in Parkinsons disease, Dr. Ali Rezai, executive chair of the WVU Rockefeller Neuroscience Institute, said. In this study, AAV-GAD gene therapy is delivered to the subthalamic nucleus, a key area with dysfunction in a brain with Parkinsons disease. Over time, the gene therapy is intended to help Parkinsons disease by making new brain connections and improving symptoms.

The first participant is a grandparent of 14 from West Virginia who was forced to retire because of the progression and severity of Parkinsons disease.

Medications had become less effective with worsening side effects.

They hope their participation in this study not only helps them find relief, but also leads to advances in treatment for others with Parkinsons.

I hope this gene therapy will help my Parkinsons and also help other people, the participant said.

For more information on the study, .

Copyright 2022 WDTV. All rights reserved.

Most Read

Medication Names And Forms

Most medications have two names. The generic name describes the active ingredient in the drug. Every drug that has the same active ingredient will have the same generic name, no matter who manufactures it. The different drug companies who produce the medication market it using a brand or trade name and these may vary from country to country.

For example, the levodopa group of drugs can exist in a number of forms. Each of these contains the chemical levodopa in combination with a second chemical called carbidopa. Together, these are referred to as co-careldopa.

Not all medications are available in each of the European countries, and they may have different brand names. You can obtain further details from your national regulatory authority. Contact details can be obtained from the European Medicines Agency website.

European Journal Of Internal Medicine

Another study, driven by Agnelli, and published in the European Journal of Internal Medicine in 2018, asserted that marijuana was a safe and effective method of treating symptoms of PD in older patients. The study stated that marijuana patients experienced a significant decrease in pain. After six months of use, 18% of patients diminished or discontinued opioids as painkillers.

You May Like: How Do You Check For Parkinson’s

What Foods Are Good Sources Of Protein

Good sources of protein include both animal and plant sources. Plant sources include beans, lentils, peas, nuts, seeds, and protein alternatives. Animal sources include meat, fish, poultry, eggs, milk, and cheese.

Click here to find the amount of protein in different foods. Measure or weigh your portion size to obtain accurate results.

Impulsive And Compulsive Behavior

Some people taking dopamine agonists may experience problems with impulsive or compulsive behaviours. For example an increased desire to gamble or engage in sexual activity. These behaviours often develop slowly so may not seem to be a problem immediately. It is important for both the person living with Parkinsons and their family to be aware of this side effect. If affected by this side effect, a reduction in dose or stopping the medication will stop the behaviour.

Recommended Reading: Parkinson’s Legs Won’t Move

Parkinsons Disease Medications: The Facts

There have been many developments in Parkinsons disease treatments in recent years. As such, doctors now have a greater understanding of traditional Parkinsons disease medications and their side-effects. Scientists have also developed new drugs to help control tremors, slowed movement and other Parkinsons symptoms.

Before we explore the best medication for Parkinsons disease, its important to address the facts. Firstly, Parkinsons disease medications cannot cure your condition, nor will they slow down the progression of your symptoms. These medications are prescribed to help patients live independently and improve their quality of life.

Its important to note that some patients do not respond well to Parkinsons disease medications. In this case, there are plenty of other treatment options to consider such as homeopathic remedies, physical therapy and surgical intervention. Again, none of these treatments provides a cure, but they can help ease or control your symptoms.

Dont Miss: Parkinsons Education For Nurses

Side Effects And Problems With Levodopa

In the early days of taking levodopa, you may feel sickness or nausea. In most people this will pass as your body adjusts to the medication.

Overtime as Parkinsons progresses the levodopa dose will need to be adjusted. Many people will become more aware that symptoms sometimes return between doses of medication. This is called wearing off and is a sign your dose needs to be adjusted.

As levodopa is absorbed through the gut, constipation or other stomach problems may impact on uptake of the medication. In some people who have had Parkinsons for sometime extra involuntary movements can occur. Your neurologist will be able to help adjust medications to minimise dyskinesia.

Other side effects may include:

• Psychological changes
• Sleepiness, fainting or dizziness

Side effects of levodopa can sometimes be improved by changing your dose, the form of the drug or how often you take it. If this doesnt work, other types of drug may be combined with levodopa.

Speak to your GP or specialist about the right treatment for you.

You May Like: What Happens When You Have Parkinson’s Disease

Mechanism Of Action Of Available Drugs

The major classes of drugs currently available for the treatment of idiopathic Parkinsons disease are shown in Table 1. Many aim to increase dopamine in the brain, by increasing its production or altering its metabolism .

Drugs with alter metabolism in boxed red italics

Levodopa

Levodopa is absorbed from the small intestine and transported into the brain where it is converted to dopamine. Levodopa has a short plasma half-life of about one hour. Early in Parkinsons disease, levodopa has a long duration of action which is independent of plasma concentration, but as the disease progresses, the duration of the effect reduces. The short-duration effect is strongly linked to plasma concentration and lasts, at most, hours.

Slow-release preparations are gradually absorbed, resulting in more sustained plasma concentrations. They have reduced bioavailability higher doses are required to match the benefit of an equivalent strength of a standard preparation. Rapid release preparations are taken in liquid form to enhance passage through the stomach and absorption from the small intestine.

Dopamine agonists

Apomorphine is a potent emetic so patients must be pre-treated with domperidone 20 mg three times daily orally for at least 48 hours before the first injection. Domperidone should be continued for at least a few weeks once regular intermittent treatment has commenced. The dose can then be tapered slowly as tolerance to the emetic effects of apomorphine usually develops.

Controlled Release Madopar And Sinemet

Controlled release preparations have the letters CR or HBS after the drug name.

These let the levodopa enter your body slowly instead of all at once. They can increase the time between doses.

They may be used when the dose of standard levodopa starts to wear off and the person taking it no longer feels the treatment is effective.

Controlled release options can sometimes reduce involuntary movements .

Also Check: Vitamins And Herbs For Parkinson’s Disease

An Approach To The Treatment Of Parkinson’s Disease

No treatment can arrest or slow neurodegeneration in Parkinson’s disease. The aim is to relieve symptoms and avoid the complications of therapy.

Early Parkinson’s disease

Many studies have shown that early treatment with dopamine agonists reduces the incidence of dyskinesia.1Fewer motor fluctuations were shown in some but not all of the studies. We recommend a dopamine agonist as the first treatment in younger patients who have mild disease and no cognitive deficit. It is necessary to add levodopa within 1-5 years in most patients. In more severe disease, treatment begins with levodopa but a dopamine agonist may be added to keep the daily dose of levodopa in the lower range if there is no cognitive deficit. Dopamine agonists are used infrequently and with caution in patients more than 70 years old because of the risk of neuropsychiatric adverse effects and postural hypotension. They are contraindicated in the presence of dementia.

Isolated resting tremor is rarely disabling, but if it interferes with function it can usually be managed with levodopa. When this is ineffective at low to moderate doses, the addition of an anticholinergic can sometimes be useful.

Patients with motor fluctuations

Role of physical therapy and surgery

When To Start Levodopa In Parkinson’s Disease

Dopamine is a neurotransmitter secreted from the substantia nigra, a small region in the brainstem that withers away in Parkinson’s disease. As natural dopamine levels in the brain begin to fall, signs of Parkinson’s disease appear. If dopamine is replaced, many of the symptoms improve.

One would think, then, that dopamine should be given as soon as possible. There are other options, though. In addition to given dopamine directly , Parkinson’s disease patients may benefit from a class of drugs called dopamine agonists. These are drugs that aren’t dopamine but have similar effects on the nervous system. Some physicians have argued that dopamine agonists should be used earlier in the disease’s course and that only elderly patients with at least moderate disability should receive levodopa.

Recommended Reading: How To Cure Parkinson’s Naturally

Some Disadvantages Of Comt Inhibitors

These drugs can increase the side effects caused by levodopa, notably dyskinesias , nausea and vomiting.

If these side effects increase after starting the drug, people should raise the issue with their healthcare professional, as reducing the levodopa dose can often help.

COMT inhibtors will discolour urine making it a reddish-brown colour. Some people also experience diarrhoea which may occur some months after commencing the medication.

Be aware that other drugs for Parkinsons or other conditions can affect the action of COMT inhibitors. The combination of apomorphine and entacapone needs careful supervision.

Side Effects And Problems Of Anticholinergics

Another reason these drugs are not a first choice for treating Parkinsons are their side effects. Some people may experience confusion, a dry mouth, constipation and blurred vision when taking anticholinergics.

Anticholinergics may interfere with levodopa absorption in the small bowel, which reduces the effectiveness of Madopar or Sinemet, forms of the drug levodopa.

Anticholinergics are not usually prescribed to older people with Parkinsons because there is an increased risk of memory loss and, in men, problems urinating.

Recommended Reading: What Treatment Is There For Parkinson’s Disease

Treatment Of Late Stage Complications Of Parkinsons Disease

Postural hypotension

Levodopa and dopamine agonists worsen postural hypotension and it may be necessary to lower the dose of levodopa or withdraw the agonist. Treatment is difficult, but patients should be advised to sleep with the head of the bed raised by one or two bricks and to add salt to their diet. Fludrocortisone can then be added at a dose of 0.1 mg in the morning, increasing if necessary up to 0.5 mg in the morning. If these measures are ineffective, the alpha agonist midodrine 10-20 mg four hourly can be useful but it is experimental and only available via the Special Access Scheme. Patients treated for postural hypotension need to have electrolytes, renal function and supine blood pressures closely monitored.

Parkinsonian psychosis, depression and dementia

Psychotic symptoms such as visual hallucinations and persecutory delusions occur most commonly in the setting of dementia, which may be mild and therefore easily missed. Most drugs for Parkinsons disease make these symptoms worse. Depression is also common and requires treatment in its own right.

What Did It Find

• According to the UPDRS score, there was no difference in the progress of disease between the early-start group and the delayed-start group , .
• The estimated rate of change in progression of the disease, a secondary outcome, was similar in both groups between 4 and 44 weeks .
• Due to needing symptomatic relief, 87 people in the delayed-start group had levodopa before week 40.
• The estimated rate of change in progression was faster between weeks 44 and 80 in the early-start group . This means starting levodopa earlier did not slow disease progression.
• At 80 weeks, a similar proportion of participants were suffering complications, such as involuntary movements, from levodopa treatment .

You May Like: What Is The Meaning Of Parkinson’s Disease

Names Of Parkinsons Drugs

Drugs for Parkinsons can be divided into three categories.

On our website, we have listed drugs in the following order to help you see each category clearly.

• The class or type of drug, for example levodopa.
• The generic name, such as co-beneldopa, which will include the active ingredients of the drug. For example, co-beneldopa is a combination of levodopa and benserazide.
• The brand name. For example, Madopar is the name that the pharmaceutical company, Roche, uses to sell co-beneldopa.

Your specialist will decide whether to prescribe you branded or generic versions of your medication. It usually depends on which area of the country you are in or what is most common to prescribe in that area. Once there are no longer any legal rights to the brand name any company can make generic versions of a drug.

The active ingredient of a generic drug is always the same as the branded version and lots of people wont have any problems using the generic medication.

In the UK, a generic or branded medicine needs a licence and there is a strict process for this. This means that the quality of a generic or branded version of the same medicine will be the same, and they will also act in the same way.

If you find that you respond a bit differently to generic medication, discuss this with your specialist or Parkinsons nurse.

The brand name will usually be the most visible name on your packet of medication. The generic name is usually written in small print.

Tips To Eat Enough Protein Around Your Dosing

You may or may not notice that eating foods with protein and taking your medication together make a difference in your Parkinsons signs and symptoms. If you do, talk to your doctor, and ask if this rule of thumb and dosing scenario below could work for you. Of course, remember to change the times based on when you wake up in the morning but keep the intervals the same.

Also Check: Can Wellbutrin Help Parkinson’s

Causes Of Parkinsons Disease

At present, we do not know the cause of Parkinsons disease. In most people there is no family history of Parkinsons Researchers worldwide are investigating possible causes, including:

• environmental triggers, pesticides, toxins, chemicals
• genetic factors
• combinations of environment and genetic factors

What Should I Know About Parkinsons Disease And Medications

There have been rapid and remarkable changes over the past decade in treating Parkinsons disease . The development of new medicines and the understanding of how best to use them and the older drugs have significantly improved the quality of life for people with the disease.

There is currently no treatment that has been proven to affect the disease progression or development of medication that can slow the disease process. There are two general approaches to the treatment of PD improve the symptoms with medications and engage in physical therapy. Most patients with PD can be adequately treated with medicines that alleviate their symptoms. For the approximately 15% of patients for whom medicines are not sufficiently effective, new, highly effective, and safe surgical treatments are available.

Choices about medicines made early in the course of the disease have a strong impact on the long-term course of the illness. Therefore, you should seek the advice of doctors specially trained in treating PD even when the illness is only suspected. Movement disorders specialists are neurologists who have completed their training in neurology and have received special advanced training in treating PD and other related diseases.

Read Also: Does Agent Orange Cause Parkinson’s

Speech And Occupational Therapy

Parkinsons disease can lead to slurred speech and difficulty swallowing. A speech and language therapist can provide muscle training techniques that may help overcome some of these problems.

An occupational therapist can help identify everyday tasks that can be challenging and work with the person to find practical solutions.

This may include new strategies for dressing, preparing meals, performing household chores, and shopping. Adaptations to the home environment can also make daily living easier.

For people with Parkinsons disease, deep brain stimulation may help manage:

• an electrode inside the part of the brain that controls movement
• a pacemaker-like device, or neurostimulator, under the skin in the upper chest
• a wire under the skin connecting the neurostimulator to the electrode

The neurostimulator sends electrical impulses along the wire and into the brain via the electrode. These impulses can prevent symptoms by interfering with the electrical signals that cause them.

There is a small risk of brain hemorrhage, infection, and headaches. Some people may see no improvement, or their symptoms may worsen. There may also be discomfort during stimulation.

Nevertheless, the AAN considers this treatment safe and effective for specific people and say any adverse effects are usually mild and reversible. Anyone considering this treatment should discuss the pros and cons with a healthcare professional.

Treatment Of Late Stage Complications Of Parkinson’s Disease

Postural hypotension

Levodopa and dopamine agonists worsen postural hypotension and it may be necessary to lower the dose of levodopa or withdraw the agonist. Treatment is difficult, but patients should be advised to sleep with the head of the bed raised by one or two bricks and to add salt to their diet. Fludrocortisone can then be added at a dose of 0.1 mg in the morning, increasing if necessary up to 0.5 mg in the morning. If these measures are ineffective, the alpha agonist midodrine 10-20 mg four hourly can be useful but it is experimental and only available via the Special Access Scheme. Patients treated for postural hypotension need to have electrolytes, renal function and supine blood pressures closely monitored.

Parkinsonian psychosis, depression and dementia

Psychotic symptoms such as visual hallucinations and persecutory delusions occur most commonly in the setting of dementia, which may be mild and therefore easily missed. Most drugs for Parkinson’s disease make these symptoms worse. Depression is also common and requires treatment in its own right.

Also Check: Does Smoking Cause Parkinson’s Disease