Treatment Goals for Parkinson's Disease

Treatments for Parkinson’s disease (PD) focus on:¹

• Relieving or controlling the symptoms of PD for as long as possible
• Minimizing drug side effects
• Improving quality of life

Treatment is tailored to each person's specific needs, so medicines, dosages, and timing of dosages vary.

There is no known cure for PD, and there are no treatments that can change the course of the disease or stop the progression. Current research seeks ways to stop the progression of the disease.¹

Goals of drug treatments for motor symptoms

The motor symptoms of PD are caused by reduced levels of the neurotransmitter dopamine in the brain. Dopamine is the chemical messenger that contributes to smooth, purposeful movement. Low levels of dopamine causes symptoms like:^1,2

• Resting tremor
• Bradykinesia (gradual loss and slowing down of spontaneous movement)
• Rigidity
• Postural instability (impaired balance)

The main drug treatments used for PD help increase dopamine levels in the brain. By doing so, they relieve the symptoms of PD.^1,2Levodopa combined with carbidopa is generally given as the first treatment. Levodopa is a precursor to dopamine. Carbidopa keeps the body from turning levodopa into dopamine so more of the levodopa gets to the brain. This also reduces side effects caused by dopamine in the rest of the body.^1,2

Other drugs used to treat motor symptoms include:^1,2

• Monoamine oxidase (MAO)-B inhibitors
• COMT inhibitors
• Dopamine agonists
• Anticholinergics
• Amantadine

Treatment goals for non-motor symptoms

Not every person with PD develops the same symptoms, and not everyone develops non-motor symptoms. However, non-motor symptoms of PD can be more disabling than motor symptoms and greatly impact quality of life.^1,3

Non-motor symptoms of PD affect a range of brain and body functions. They may include:^1,3

• Fatigue
• Gastrointestinal issues, such as constipation
• Urinary issues
• Sleep problems
• Orthostatic hypotension (a drop in blood pressure that occurs upon standing)
• Pain
• Reduced sense of smell
• Mood changes, like depression or anxiety
• Cognitive changes, like slowed thinking, confusion, or difficulty orienting oneself in familiar locations
• Hallucinations, delusions, or paranoia
• Sexual dysfunction
• Weight loss or weight gain
• Vision problems
• Dental problems
• Skin problems
• Impulsive behaviors

At the late stages of the disease, dementia can also develop as a symptom of PD.^1,3

Some drugs used to treat motor symptoms, including levodopa, cause non-motor symptoms as a side effect. Managing non-motor symptoms focuses on:³

• Addressing underlying problems that may be contributing to symptoms
• Reviewing all medicines a person is taking
• Reducing or eliminating any drugs that may be causing the symptoms
• Adding other drugs or therapies to reduce symptoms

Physical therapy goals for Parkinson’s disease

Exercise therapy in people with PD improves motor symptoms and helps people maintain their functional independence. The goals of physical therapy and exercise are to help improve:^1,2

• Balance
• Mobility
• Speech
• Other functional abilities

Surgical goals for Parkinson’s disease

Some people with PD with advanced-stage disease are candidates for surgery to help control motor symptoms.

Deep brain stimulation is the most common surgery used to treat PD. This involves the implantation and activation of electrodes into the brain. Goals of the surgery are to reduce motor symptoms that are not well controlled with medicine.^1,2