One to two Americans out of every 1,000 have Parkinson's disease, according to Dr. Roger Simon, chairman of neurology at Legacy Health Systems, in the book "Clinical Neurology." As many women suffer with this disease as men. The symptoms initially start when most people are in their 50s. But there are several remedies available to help those afflicted with this disorder.
Anticholinergics
Acetylcholine and dopamine are neurotransmitters. They are chemical substances that are released by the nerves to stimulate cells and tissues. They need to be in balance with each other for people to be able to move in a normal way. According to "Clinical Neurology," in Parkinson's disease, there is a loss of dopamine in the area of the brain called the substantia nigra. This means the balance between acetylcholine and dopamine is lost, leaving more acetylcholine than dopamine. Anticholinergics are remedies that lower the acetylcholine levels to restore the balance between the two neurotransmitters. Trihexyphenidyl and benztropine are anticholinergic medications.
Dopamine Agonists
There are protein molecules called receptors within a cell or on the membrane of a cell. They get signals that tell them what to do. Dopamine agonists are medications that stimulate dopamine receptors to make them release dopamine. Increasing the levels of dopamine helps restore the balance between dopamine and acetylcholine. Bromocriptine, pergolide, ropinirole, pramipexole and apomorphine hydrochloride are all dopamine agonist remedies.
Amantadine
Dr. David Eidelberg, professor of neurology and neurosurgery at New York University School of Medicine writes in the "The Merck Manual for Healthcare Professionals" that the remedy called amantadine possibly increases the activity of dopamine and anticholinergics. Physicians are not sure how it works.
Levodopa-Carbidopa
Levodopa is a remedy for Parkinson's disease that is changed in the body to dopamine but does not stop the disease from progressing, according to Dr. Michael Aminoff, professor of neurology at the University of California in "Current Medical Diagnosis & Treatment." The body uses an enzyme, called dopa decarboxylase, to change levodopa to dopamine. Enzymes are proteins that speed up the amount of time a process would take. But the enzyme that changes levodopa changes it before it reaches the brain. So, carbidopa is given because it interferes with this enzyme. As a result, less levodopa is changed outside the brain, which also means that less levodopa is needed. Sinemet is a medication that contains both levodopa and carbidopa.
COMT Inhibitor
Aminoff explains in "Current Medical Diagnosis & Treatment" that COMT inhibitors are remedies that interfere with an enzyme called catecholamine-o-methyltransferase. This enzyme breaks down dopamine. Interfering with this enzyme leads to less dopamine being metabolized, which leaves more dopamine available for the brain. Entacapone and tolcapone are COMT inhibitors that are sometimes used with levodopa and carbidopa. Stalevo is a remedy that has levodopa, carbidopa and entacapone.
MAO-B Inhibitor
Monoamine oxidase B is another enzyme that metabolizes dopamine. Similar to COMT inhibitors, interfering with monoamine oxidase B will decrease the breakdown of dopamine. This will result in more dopamine for the brain to use. In "The Merck Manual for Healthcare Professionals," Eidelberg writes that selegiline and rasagiline are MAO-B inhibitors.
References
- "Clinical Neurology"; Roger Simon, M.D., David Greenberg, M.D., Ph.D., Michael Aminoff, M.D.; 2009
- "Current Medical Diagnosis & Treatment 2010"; Stephen McPhee, M.D., Maxine Papadakis, M.D.; 2010
- The Merck Manual for Healthcare Professionals: Parkinson's Disease
