Treatment for Parkinsons Disease

There is currently no available cure for Parkinsons disease. However, treatment is used effectively to minimise the disability it causes and reduce side effects of drug therapy whilst helping the patient continue their life with the highest quality possible.

Prescribed medications are used to help assist in the management of the symptoms of the condition although medication cannot stop the progression of the disease. Management of each individual’s treatment is very individualised and determined by a doctor who has special interest in the treatment of the disease. Those individuals suffering with mild symptoms which do not necessarily interfere with their everyday life do not always require medication.

There are several drugs available to treat the symptoms of the disease and some of these may actually cause the symptoms themselves if not carefully prescribed. If a specialist is able to determine which of the medications being used is causing the Parkinson-like symptoms, that medication may well be stopped or perhaps altered to another medication whilst the symptoms are closely monitored for change or improvement. Recommendations for medication are usually made soon after Parkinsons disease is diagnosed.

Selegiline (Eldepryl)is a useful drug due to it being a neuroprotective drug. (These assist in rescuing brain cells and slow or stop Parkinson’s disease from progressing). If the sufferer is symptomatic and experiences difficulties with their mobility, levodopa and carbidopa (Sinemet), or a COMPT inhibitor such as entacapone (Comtan) or tolcapone (Tasmar), or a dopamine agonist such as bromocriptine (Parlodel), ropinirole (Requip), a pergolide (Permax) or pramipexole (Mirapex can be commenced. These are usually very effective at least for a while.

If a medication no longer controls the symptoms effectively, another drug can be added to the therapy. Specialists usually try and reserve levodopa and carbidopa for use later in the progression of the disease. This is because despite its benefits, it has the unfortunate side effect of causing movement dysfunction if started too early. Stalevo is a drug which has been recently developed and combines levodopa/carbidopa and entacapone in a single tablet. Patients who are at present taking carbidopa/levedopa (Sinemet) can use entacapone (Comtan) as separate medications.

Those patients suffering from severe or fast-progressing Parkinsons disease where all other therapies have failed may consider surgery. A surgical technique called Pallidotomy can be used where an electric probe is used to destroy a small portion of the brain which is overactive and thought to cause the symptoms of Parkinsons disease. Another surgical procedure known as a Thalamotomy can also be considered. This is a removal of part of the thalamus region of the brain. The thalamus is responsible for involuntary movements and by destroying it, it prevents involuntary movements. This type of surgery is rarely performed and is the last resort for those patients who are suffering from involuntary movements and disabling tremors in the arm or hands. The procedure does not relive other symptoms of the disease.

Another type of treatment is thalamic stimulation. This procedure consists or an electrode wire being inserted into the thalamus. The other end of the wire is connected to a pulse generator which is placed under the skin around the chest area. The device can provide the benefit of Thalamotomy without causing scars or wounds on the skin and has been proved to be a very effective management technique in tremor symptoms of Parkinsons disease.

A new, alternative procedure is known as Deep Brain Stimulation (DBS). This procedure destroys the small region of the brain where a thin electrode implanted into the brain blocking brain waves that can cause the uncontrollable movements