Parkinson's disease is caused by a loss of brain cells that produce dopamine, a neurotransmitter with many functions including voluntary movements, sleep and memory. Diagnosis is made based on findings of trembling of the limbs and face, slow movements, problems with balance and stability, and stiffness of the body, according to Merck Manuals Medical Library. Treatment options involve medications, surgery and physical therapy.
Levodopa
Levodopa, or L-dopa, is a drug that is changed to dopamine in the brain. It is usually administered along with another medication called carbidopa, which helps prevent levodopa from being broken down too quickly. Combining the drugs allows for a lower dose of levodopa, reducing the side effects of nausea and vomiting. Since the mid-1970s, levodopa has been the primary drug used in the treatment of Parkinson's disease, reports the National Parkinson Foundation.
COMT Inhibitors
Catechol O-methyltransferase, or COMT inhibitors, are a class of drugs that slow the breakdown of dopamine and therefore prolong the action of levodopa. They are often used in combination with levodopa and carbidopa. COMT inhibitors can help reduce a person's dose of levodopa.
Amantadine
This drug can be used alone or in combination with levodopa. It is most useful in mild or early disease, but can lose effectiveness when used as a single drug. It is most useful in treating the symptoms of uncontrollable writhing movements, called dyskinesia.
Dopamine Agonists
These drugs stimulate dopamine receptors in the brain and can be used at any stage of the disease, but are particularly helpful in the late stages of Parkinson's as the benefits of levodopa begin to wane.
MOA-B Inhibitors
MAO-B inhibitors block an enzyme that breaks down dopamine in the brain, and so extends the action of levodopa.
Anticholinergic Drugs
The neurotransmitter acetylcholine is important in the stimulation and contraction of muscle tissue. Anticholinergics block the activity of acetylcholine and help to reduce tremors and stiff muscles. These medicines are used alone or in combination with levodopa. Anticholinergics can cause confusion and should be used with caution in elderly people.
Surgery
Most people with Parkinson's are managed on drug therapy, but some may benefit from surgery. Electrical deep brain stimulation, or DBS, is one method of surgical treatment whereby an implanted electrode corrects abnormal brain activity, describes the American Association of Neurological Surgeons. In another surgical procedure called lesioning treatment, a heated probe is used to destroy abnormally active brain tissue in a small area of the brain.
Activity
Physical therapy can help alleviate many of Parkinson's symptoms. Decreasing slowness of movement, decreasing stiffness, and improving balance and gait are some of the benefits of these therapies. Occupational therapy aims to improve the overall quality of life for those with Parkinson's through increasing activity levels and by providing tools to develop independence.
