How Is Parkinson's Disease Treated?

Parkinson’s disease (PD) is a chronic, progressive disease that affects the brain and the body. There is no known cure for PD. There are also no treatments that can slow the progression of the disease.^1,2

Treatment for PD is focused on managing symptoms and improving quality of life. While PD has some common features and symptoms, the disease varies from person to person. Because of this, doctors customize treatment to meet the unique needs of each person with PD.^1,2

Medicines

Nearly everyone with PD will take some type of medicine, and there are several different types of drugs used to treat the symptoms of PD. Some medicines are used to improve the motor symptoms of PD, such as tremor, slowed movement, and rigidity. Other medicines may be used for non-motor symptoms that a person with PD may have, such as mood changes, cognitive challenges, and hallucinations.^1-3

The most common medication for PD is the combination of levodopa and carbidopa, which directly provide the neurotransmitter dopamine to the brain These medicines can help improve the motor symptoms of PD. Some common brand names for levodopa and carbidopa include Rytary®, Sinemet®, and Duopa®.^1-3

Other types of drugs that may be used for PD include:^1-3

• Dopamine agonists – These act like dopamine in the brain. Examples include Apokyn™ (apomorphine), Mirapex® (pramipexole dihydrochloride), and Neupro® (rotigotine).
• Anticholinergics – These help control tremors. Examples include Cogentin® (benztropine mesylate) and trihexyphenidyl.
• MAO-B inhibitors and COMT inhibitors – These slow down the parts of the brain that break down dopamine. Examples of MAO-B inhibitors are Azilect® (rasagiline), Xadago® (safinamide), and Zelapar® (selegiline hydrochloride). Examples of COMT inhibitors are Comtan® (entacapone) and Ongentys® (opicapone).
• Amantadine – This medicine helps with early-stage PD symptoms. In the later stages of PD, it can help with involuntary movements.
• Adenosine receptor antagonists – These help the brain release more dopamine. One example is Nourianz® (istradefylline).
• Nuplazid® (pimavanserin) – This drug helps treat hallucinations.

Deep brain stimulation

Deep brain stimulation (DBS) is a surgery that may help some people with PD. In this surgery, a small electrode is placed at a specific part of the brain. There is also a generator implanted near the collarbone. After the surgery, the generator sends electric pulses to the electrode. The pulses impact brain activity and help with some motor symptoms like tremors.^2,3

Surgical options

DBS is the most common type of surgery for PD. Another common type of surgery is called Duopa therapy. In Duopa, you will first receive a small port in your intestine. Then, levodopa and carbidopa are given directly into the intestine through this port.^3,4

Other types of surgery for PD are less common. These include focused ultrasound, thalamotomy, pallidotomy, and subthalamotomy. These surgeries all involve destroying specific parts of the brain that play a role in PD.^3,4

Complementary and alternative medicine

Complementary and alternative medicine (CAM) are treatments outside traditional medicine. Research on CAM treatments is limited. Some treatments that may help with PD symptoms include:⁵

• Vitamins C and E
• Creatine
• Glutathione
• Folic acid
• Ginger
• Green tea

Tell your doctor about any CAM treatments you are interested in. Supplements can interact with prescription drugs. Additionally, supplements are not regulated in the same way as other drugs.⁵

Exercise

Gentle exercises that strengthen muscles can help improve balance, flexibility, and coordination. Some types of exercise that may help include yoga or tai chi. A good exercise plan will challenge different parts of the body.^1,2

Physical and occupational therapy

Physical therapists can also recommend an exercise routine for you. Working with a physical therapist can help improve your walk, balance, and flexibility. Occupational therapy can help with fine motor skills. These are the skills that help with things like eating or buttoning clothing.^3,5

Nutrition and diet

Maintaining a healthy diet can help manage some PD symptoms. Diet changes that may help include:^2,3,5

• Eating lots of fiber
• Drinking lots of healthy fluids
• Eating food high in omega-3 fatty acids, like salmon or olive oil
• Getting enough calcium

Some people may avoid protein because it can impact how levodopa and carbidopa are absorbed. If protein impacts your PD drugs, try eating it later in the day. Getting enough protein in your diet is important.^3,5

Mental health and therapy

Depression and mental health struggles can be common for people with PD. There are ways to improve your mental health:^2,3

• Joining a support group to connect with other people with PD
• Speaking with a mental health professional in talk therapy, such as a psychologist or social worker
• Taking antidepressants

Maintaining your hobbies and social life can also help your mental health. Take time to see friends or family. Staying positive and present can also help.^2,3