At present, there is no treatment to slow or halt the progress of Parkinson’s disease. Treatment focuses instead on the most bothersome symptoms for each individual, like tremors, slowness, or stiffness. There is no standard or most effective treatment for Parkinson’s disease; the choice of medication or surgery is based on each individual patient.
Perhaps the most commonly prescribed medication for Parkinson’s disease is levodopa. This medicine is converted to dopamine by enzymes in the brain, and helps reduce the symptoms of slowness, stiffness, and tremor in most patients. Levodopa is paired with some kind of enzyme inhibitor to prevent enzymes in the blood from breaking the drug down before it gets to the brain.
Another class of medication prescribed for Parkinson’s disease is known as dopamine agonists. Unlike levodopa, these medications do not need to be modified by enzymes in the brain. There are several different types of dopamine agonist; each one is somewhat different. Your doctor may try several different dopamine agonists before finding one that works best for the patient.
In addition to levodopa or a dopamine agonist, your doctor may suggest other medications to alter the movement control center in the brain of a person with Parkinson’s disease. Amantadine helps ease symptoms of tremor in the early stages of Parkinson’s disease. Anticholinergic medications also can help reduce tremor and rigidity, but come with increased confusion as a side effect. Selegiline inhibits an enzyme that breaks down dopamine in the brain — inhibiting the enzyme prolongs dopamine action and can improve symptoms of Parkinson’s disease.
For most patients with Parkinson’s disease, levodopa or a dopamine agonist and other medications are effective in maintaining a good quality of life. However, as the disease progresses, patients can develop a pattern of response to treatment known as motor fluctuations. A person in what is called an “on period” can move with relative ease; a person in an “off period” can see an increased difficulty with movement and stiffness. A patient may experience an off period prior to the next dose of medication, for example. Medication adjustments may help the motor fluctuations. When medication adjustments don’t make a difference, surgery may be suggested.