Medicationsfor Parkinson’s disease (PD) do not cure the illness, but are helping peoplewho suffer from PD with the symptoms.
It is necessaryto understand and obey the protocol for taking these medications which yourdoctor prescribed. There are general combinations of medications used in PD,but the specialist would decide which medications are giving the best result. Doctorwill determine the drugs keeping in mind current health condition, medicationalready used and the patient’s age. The dose depends on mostly on patient’smetabolism and their needs.
There are severaldifferent groups of medications used to treat Parkinson’s disease: therapy thatincludes Carbidopa and Levodopa, dopamine agonists, anticholinergics, MAO Binhibitors, COMT inhibitors and some other medications.
Carbidoba/Levodopaor Sinemet® Levodopa is converted to dopamine in the brain. Dopamine thanactivates the dopamine receptors and provide normal function of the center inthe brain responsible for movement. This medication is used for over 40 yearsand it is still the most effective of all.
Combined tabletsLevodopa plus carbidopa (Sinemet®) allow more levodopa to get to the brain,without the losses of the substance when converted in the bloodstream. Plus sidesof Sinemet are smaller dose of levodopa and lesser side effects because of theadded carbidopa. The negative side effects remain – spontaneous, involuntarymovement, called dyskinesias, and “on-off” periods, when medications just stopto be effective.
Stalevo® is acombination of three medications: carbidopa, levodopa and entacapone. It isused when patients experience wearing off of the medications. Added entacaponeincrease the time during which levodopa is active in the brain.
Many medicationsinteract with with carbidopa, levodopa and entacapone, and with Sinemet andStalevo, also. You should inform the doctor if you’re taking antacids, anti-seizuremedications, anti-depressants, medications for high blood pressure or you areon a high protein diet.
Medicationscalled dopamine agonists stimulate parts of the brain that receive dopamine,tricking the brain to think it receives dopamine. These medications could beused with the levodopa medications or taken alone. Bromocriptine (Parlodel®),pramipexole (Mirapex®) and ropinirole (Requip®or RequipXL®) are the dopamineagonists available in the United States. Some earlier products, like pergolide(Permax) and Neupro® (rotigotine transdermal system) are recalled from the market. Interactionsare possible when using alcohol, anti-psychotics, medications for loweringblood pressure, Navane® , Taractan®, Haldol®, Reglan®, phenothiazines,thiozanthenes, cimetidine, phenothiazines, butyrophenones, Cipro® andbenzodiazepines.
Another typeof PD medications are anticholinergics as trihexyphenidyl, benztropinemesylate, procyclidine and some others. They decrease the amount ofacetylcholine in the brain, balancing out the production of dopamine, and areusually used for mild cases of PD. Side effects are blurred vision, urinaryretention and dry mouth, and in elderly these medications could causehallucinations and confusion. For that reasons anticholinergics are not used inolder patients. There is a need to consult a doctor f you are already using anti-histamines,Haldol®, Thorazine®, Symmetrel®, Clozaril® or alcohol.
MAO Binhibitors includes medications as selegiline and deprenyl (Eldepryl®). They areblocking the enzyme which destroys levodopa, and if the medication is used withSinemet® it may boost the therapeutic effects of Sinemet. Possible interactionsinclude anti-depressants, narcotic pain killers and decongestants, and youshould always check with the doctor if you are using those.
Entacapone (Comtan®) is an COMTinhibitor, and it must be combined with levodopa. It also blocks the enzymewhich destroys levodopa, thus providing constant supply of levodopa to thebrain.
Possible OTC(over the counter) medications for PD treatment include Coenzyme Q10, Vitamin E, C, fermented fruits (papaya, blueberries) and creatine. It is important to consult the doctor if you are using anyof these products.