Medications To Treat Parkinsons Disease
Medications for Parkinsons disease help increase dopamine or decrease acetylcholine in the brain. This can minimize trembling and other symptoms. Medications include:
- Amantadine , which is an antiviral drug that also has positive effects on jerky movements
- Anticholinergic medications, including benztropine mesylate and trihexyphenidyl , which help reduce trembling temporarily in some cases
- COMT inhibitors, including entacapone and tolcapone , which make levodopa and carbidopa more effective
- Dopamine agonists, including pramipexole , ropinirole and the patch rotigotine , which are medications that have some of the same actions as dopamine
- Levodopa, either alone or in combination with carbidopa. Levodopa is a chemical that is converted to dopamine in the brain. Carbidopa helps prevent the breakdown of levodopa, allowing more of it to reach the brain. Levodopa often becomes less effective after several years of treatment. It comes as a regular tablet , an extended-release tablet , an orally disintegrating tablet , and an intestinal infusion .
- MAO-B inhibitors, including rasagiline , safinamide , and selegiline , which allow dopamine to have a longer-lasting effect on the brain
What Treatments Are Available
Many Parkinson’s patients enjoy an active lifestyle and a normal life expectancy. Maintaining a healthy lifestyle by eating a balanced diet and staying physically active contributes to overall health and well-being. Parkinson’s disease can be managed with self-care, medication, and surgery.
Self careExercise is as important as medication in the treatment of PD. It helps maintain flexibility and improves balance and range of motion. Patients may want to join a support group and continue enjoyable activities to improve their quality of life. Equally important is the health and well being of the family and caregivers who are also coping with PD. For additional pointers, see Coping With Parkinsons Disease.
These are some practical tips patients can use:
Medications There are several types of medications used to manage Parkinson’s. These medications may be used alone or in combination with each other, depending if your symptoms are mild or advanced.
After a time on medication, patients may notice that each dose wears off before the next dose can be taken or erratic fluctuations in dose effect . Anti-Parkinsons drugs can cause dyskinesia, which are involuntary jerking or swaying movements that typically occur at peak dosage and are caused by an overload of dopamine medication. Sometimes dyskinesia can be more troublesome than the Parkinsons symptoms.
The Nervous System & Dopamine
To understand Parkinson’s, it is helpful to understand how neurons work and how PD affects the brain .
Nerve cells, or neurons, are responsible for sending and receiving nerve impulses or messages between the body and the brain. Try to picture electrical wiring in your home. An electrical circuit is made up of numerous wires connected in such a way that when a light switch is turned on, a light bulb will beam. Similarly, a neuron that is excited will transmit its energy to neurons that are next to it.
Neurons have a cell body with branching arms, called dendrites, which act like antennae and pick up messages. Axons carry messages away from the cell body. Impulses travel from neuron to neuron, from the axon of one cell to the dendrites of another, by crossing over a tiny gap between the two nerve cells called a synapse. Chemical messengers called neurotransmitters allow the electrical impulse to cross the gap.
Neurons talk to each other in the following manner :
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What Are The Symptoms Of Parkinson’s Disease
Symptoms of Parkinson’s disease differ from person to person. They also change as the disease progresses. Symptoms that one person gets in the early stages of the disease, another person may not get until lateror not at all.
Symptoms most often start between the ages of 50 and 60. They develop slowly. They often go unnoticed by family, friends, and even the person who has them.
The disease causes motor symptoms and non-motor symptoms. Motor symptoms are those that have to do with how you move. The most common one is tremor.
Tremor and other motor symptoms
Tremor, or shaking, often in a hand, arm, or leg, occurs when you’re awake and sitting or standing still . It gets better when you move that body part.
- Tremor is often the first symptom that people with Parkinson’s disease or their family members notice.
- At first the tremor may appear in just one arm or leg or only on one side of the body. The tremor also may affect the chin, lips, and tongue.
- As the disease progresses, the tremor may spread to both sides of the body. But in some cases the tremor stays on just one side.
Emotional and physical stress tends to make the tremor more noticeable. Sleep, complete relaxation, and intentional movement or action usually reduce or stop the tremor.
The most common cause of non-Parkinson’s tremor is essential tremor. It’s a treatable condition that is often wrongly diagnosed as Parkinson’s.
Besides tremor, the most common symptoms include:
What Are The Symptoms Of Parkinsons Disease
Symptoms of Parkinsons disease and the rate of decline vary widely from person to person. The most common symptoms include:
Other symptoms include:
- Speech/vocal changes: Speech may be quick, become slurred or be soft in tone. You may hesitate before speaking. The pitch of your voice may become unchanged .
- Handwriting changes: You handwriting may become smaller and more difficult to read.
- Depression and anxiety.
- Sleeping disturbances including disrupted sleep, acting out your dreams, and restless leg syndrome.
- Pain, lack of interest , fatigue, change in weight, vision changes.
- Low blood pressure.
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What Raises Someone’s Risk For Parkinson’s
It’s a complex picture, but you may be more likely to get Parkinson’s based on:
Age. Since it mostly affects people 60 and older, your risk goes up as the years go by.
Family history. If your parent, brother, or sister has it, you’re a little more likely to get it.
Job. Some types of work, like farming or factory jobs, can cause you to have contact with chemicals linked to Parkinson’s.
Race. It shows up more often in white people than other groups.
Serious head injury. If you hit your head hard enough to lose consciousness or forget things as a result of it, you may be more likely to get Parkinson’s later in life.
Gender. Men get it more than women. Doctors aren’t sure why.
Where you live. People in rural areas seem to get it more often, which may be tied to chemicals used in farming.
Infections And Gastrointestinal Microbiome
A growing number of bacterial and viral pathogens have been associated with a higher risk for developing PD. Even common gastrointestinal infections, such as norovirus, induce upregulation of -synuclein in the gastrointestinal tract, potentially in an effort to rally an immune response . Aggregated -synuclein is present in the enteric nervous system in PD patients , but it has also more recently been shown to occur in healthy people, indicating that -synuclein aggregates in the gut are not specific to PD . We propose that aggregation of -synuclein in the gut is not necessarily abnormal per se, and is most often part of an appropriate, self-contained inflammatory response following infection. We speculate that what differentiates those who develop PD from those who do not might be the presence of facilitators that amplify the -synuclein aggregates and allow for their spread along the vagus nerve, eventually causing seeding in the brainstem and Lewy pathology in the central nervous system.
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Are My Tremors Associated To Parkinsons Disease
Several neurological conditions can cause tremors and having tremors does not necessarily mean you have Parkinsons disease.
Tremors associated to Parkinsons disease are resting tremors, which occur when the body part is inactive. This typically starts in one hand, fingers, or a foot. Tremors can also affect the jaw or tongue, which can lead to communication difficulties.
As with stiffness, Parkinsons tremors mainly affect one side of the body.
If you think you have resting tremors, consult your doctor. They will perform tests to exclude any other condition often confused with Parkinsons disease.
Significant Association Between Parkinsons Air Pollution
During the study, 338 of the men and women with newly diagnosed Parkinsons were identified.
Air pollution is a significant public health hazard. More than 80 percent of urban area residents are exposed to levels that exceed limits set by the World Health Organization, adds Chung. Recently, it has been identified to be associated with neuro-degenerative diseases through systemic inflammation, oxidative stress and direct invasion into the brain.
Parkinsons is the second most prevalent, after Alzheimers disease. It affects more than six million people worldwide. A popular theory is it begins in the olfactory bulb the part of the brain that controls smell and the gut, then spreads through the central nervous system.
Therefore, exposures to environmental pollutants, such as pesticides, metals, as well as air pollution and the microbiome have been suggested as risk factors, says Chung.
In experiments on mice, exposure to ambient toxic particles were found to damage neurons that make dopamine, a hallmark of Parkinsons. The chemical kicks off movement in the body. Reduction leads to the classic symptoms of tremor, slowness and stiff muscles.
In conclusion, we identified a statistically significant association between the risk of Parkinsons and exposure to NO2 for the previous five years, especially at high exposure levels, says Chung.
The study in Jama Neurology could shed light on increasing numbers of cases.
SWNS writer Mark Waghorn contributed to this report.
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How Is Parkinsons Disease Treated
There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.
Paraquat Causes Parkinson’s New Review Creates Trouble For Trial Lawyers
A new wave of lawsuits alleges that the weedkiller paraquat causes Parkinson’s Disease. The evidence continues to undermine this claim.
Environmental activist groups and trial lawyers have launched a new campaign in their legal effort to restrict access to synthetic pesticides. We reported in late June that Syngenta and Chevron, the two largest manufacturers and distributors of the herbicide paraquat, are battling more than 150 suits alleging that the weedkiller causes Parkinson’s Disease . Making the same complaint, the Farmworker Association of Florida, represented by the non-profit EarthJustice, sued the EPA three weeks ago for re-approving paraquat.
Jeannie Economos, a pesticide safety project coordinator with the Farmworker Association of Florida said it was unconscionable that EPA so devalues the lives of farmworkers as to allow the continued use of this harmful toxic pesticide.” Assuming she’s correct about the herbicide’s toxicity, the EPA’s actions would be unconscionable. But a careful reading of the evidence indicates that Economos and her association have overstepped the evidence and exaggerated the risk posed by paraquat exposure
Follow the money doesn’t work
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Theories About What Causes Parkinsons
The cause of Parkinsons disease is still unknown, although there is some evidence for the role of genetics, environmental factors, or a combination of both. It is also possible that there may be more than one cause of the disease. Scientists generally believe that both genetics and environment interact to cause Parkinsons disease in most people who have it.
Currently, there is an enormous amount of research directed at producing more answers about what causes Parkinsons disease and how it might be prevented or cured. When physicians diagnose Parkinsons, they often describe it as idiopathic . This simply means that the cause of the disease is not known.
Eat Fresh Raw Vegetables
If you needed more reasons to eat your vegetables, this should be the clincher. Studies show that increased amounts of the B vitamin folic acid, found primarily in vegetables, can significantly reduce the risk of Parkinsons.
The best sources of folic acid are simultaneously some of the healthiest foods on the planet, namely dark green vegetables like broccoli, spinach, collard greens, brussels sprouts, asparagus and okra all of which can be grown in your backyard! This B vitamin can also be found in avocado, legumes and lentils.
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Lewy Bodies And Alpha
In addition to the dopamine deficiency and neuronal loss, PD is also associated with a buildup of intracellular inclusions inside the neurons, called Lewy bodies. Studies have shown that the Lewy bodies are made mainly of a protein called alpha-synuclein.
They are not seen in brain imaging studies but have been detected in research studies that examine the brains of people who had PD and donated their own brains to science for the purpose of research. There is no known treatment or method of removing the Lewy bodies at this time.
In PD, Lewy bodies are found in the substantia nigra as well as other areas, including the amygdala and locus coeruleus , the raphe nucleus , and the olfactory nerve . The functions controlled by these regions can be impaired in PD, although the symptoms arent as noticeable as the tremors and muscle stiffness.
What Is Niehs Doing
NIEHS supports diverse research, involving experts from many disciplines, to uncover what may cause or help prevent Parkinsons disease. Varied methods are important because no one can predict which paths of study will provide major breakthroughs. Basic research on Parkinson’s will continue to help us advance our understanding of the disease. Highlights from NIEHS research are described below, grouped by environmental factors that may affect Parkinsons and by research approaches.
Mounting evidence, from animal and human studies, suggests that exposure to certain types of pesticides can increase a persons risk of developing Parkinson’s disease.
Some people are more vulnerable to the harmful effects of pesticides because of their age or genetic makeup.
- Many studies identified genetic variations that provide insight into why certain people appear to be at higher risk of developing Parkinsons.
- Using data from the NIEHS-conducted Agricultural Health Study, researchers found that Parkinson’s risk from paraquat use was particularly high in people with a particular variant of a gene known as GSTT1.5
- Similarly, other research has indicated that people with lower levels of the PON1 gene, which is important for the metabolism of organophosphate pesticides, showed faster progression of the disease.6
Diet and Lifestyle
Some of the risk factors and premotor symptoms that may be involved in Parkinson’s.
What Is Parkinsonism Is It Different From Parkinsons
Parkinsons disease is the most common cause of parkinsonism, a category of neurological diseases that cause slowed movement.
No quick or easy diagnostic tests exist for Parkinsons disease, so a patient may receive an initial diagnosis of parkinsonism without a more specific condition being confirmed.
Classic Parkinsons disease referred to as idiopathic because it has no known cause is the most common and most treatable parkinsonism.
About 15 percent of people with parkinsonism have atypical variants, which are also known as Parkinsons plus syndromes.
The Genetics Of Parkinsons
A 2020 study including 1,676 people with Parkinsons in mainland China suggested that genes play a role in the development of the condition. An estimated 10 to 15 percent of people with Parkinsons have a family history of the condition.
In fact, a number of specific genes have been linked to the development of Parkinsons.
How do genetics factor into Parkinsons in some families? According to Genetics Home Reference, one possible way is through the mutation of genes responsible for producing dopamine and certain proteins essential for brain function.
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What Are The Symptoms
Symptoms of PD vary from person to person, as does the rate of progression. A person who has Parkinson’s may experience some of these more common “hallmark” symptoms:
- Bradykinesia – slowness of movement, impaired dexterity, decreased blinking, drooling, expressionless face.
- Tremor at rest – involuntary shaking that decreases with purposeful movement. Typically starts on one side of the body, usually the hand.
- Rigidity – stiffness caused by involuntary increase in muscle tone.
- Postural instability – sense of imbalance. Patients often compensate by lowering their center of gravity, which results in a stooped posture.
Other symptoms that may or may not occur:
Freezing or being stuck in place Shuffling gait or dragging of one foot Stooped posture Cognitive impairment
Causes Of Parkinson’s Disease
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Parkinson’s disease is a degenerative disorder of the central nervous system. Most people with PD have idiopathic Parkinson’s disease . A small proportion of cases, however, can be attributed to known genetic factors. Other factors such as environmental toxins, herbicides, pesticides, and fungicides, have been associated with the risk of developing PD, but no causal relationships have been proven.
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What Causes Parkinsons Disease
Parkinsons disease is a chronic, progressive neurological disease that currently affects about 1 million Americans. Parkinsons disease involves a small, dark-tinged portion of the brain called the substantia nigra. This is where you produce most of the dopamine your brain uses. Dopamine is the chemical messenger that transmits messages between nerves that control muscle movements as well as those involved in the brains pleasure and reward centers. As we age, its normal for cells in the substantia nigra to die. This process happens in most people at a very slow rate.
But for some people, the loss happens rapidly, which is the start of Parkinsons disease. When 50 to 60 percent of the cells are gone, you begin to see the symptoms of Parkinsons.