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Parkinson's Disease
See Also:
Parkinson's
Disease: Introduction
Parkinson's
Disease: Forms
Parkinson's
Disease: Causes & Risk Factors
Parkinson's
Disease: Signs & Symptoms
Parkinson's
Disease: Stages
Parkinson's
Disease: Medical Tests & Diagnosis Methods
Parkinson's
Disease: Treatment
Treatment Options
| Unfortunately,
there is no cure for Parkinson's Disease, but
medications or surgery can provide some relief. Selection
of medicine, drug dosage and modification of
regimens is tailored for each patient depending
on various factors such as severity of symptoms,
age and presence of other medical conditions.
This process involves experimentation,
persistence and patience since the efficacy of
drugs and symptoms are unpredictable in each
case.
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Medications:
Medications are categorized into the following three
categories:
1. The first category of drugs works
directly or indirectly to increase dopamine levels in the
brain and are called dopamine precursors. Levodopa is an
example of this type. Some drugs mimic dopamine (dopamine
agonists) and prevent or slow the break down of dopamine.
Levodopa (L-3,4-dihydroxyphenylalanine) is used by
nerve cells to produce and replenish the dwindling supply
of dopamine in the brain. Carbidopa is given along with
Levodopa to delay the conversion of levodopa to dopamine
until it reaches the brain. Side effects of levodopa
include nausea, vomiting, low blood pressure,
restlessness, drowsiness, hallucinations and psychosis.
Examples of dopamine agonists include Apomorphine,
Bromocriptine, Pramipexole and Ropinirole.
2. The second category affects
neurotransmitters in the body to ease some symptoms of
Parkinson's Disease. These drugs reduce tremors and
muscle stiffness. Anticholinergic drugs interfere with
production and uptake of neurotransmitter acetylcholine.
Examples of acetylcholine anticholinergics include
Trihexyphenidyl, Benztropine and Ethopropazine.
3. The third category of medications
help control non-motor symptoms of the disease i.e.,
symptoms not affecting the movement. For example,
antidepressants are prescribed for patients suffering
from Parkinson's Disease related depression.
Examples of antidepressants include Amytriptyline,
Fluoxetine, Benzodiazepines and Fludrocortisone.
In addition to the above, the following drugs may also
help alleviate the symptoms of PD:
MAO-B inhibitors: Selegiline
(deprenyl) and Rasagiline. These drugs cause dopamine
to accumulate in surviving nerve cells and reduce
symptoms of PD. “These drugs inhibit the
enzyme monoamine oxidase B, or MAO-B, which breaks
down dopamine in the brain.”
COMT inhibitors
(catechol-O-methyltransferase inhibitors):
Entacapone and Tolcapone.
Catechol-O-methyltransferase is an enzyme that helps
break down dopamine. These drugs inhibit COMT and
consequently help in alleviating the symptoms of PD.
Amantadine: This is an antiviral
drug used to help reduce symptoms of PD and levodopa
induced dyskinesia (8).
Surgery:
There are five types of surgery for Parkinson's
Disease:
Thalamotomy: A
tiny area in the thalamus, a part of the brain,
is destroyed with the help of stereotaxic
surgery. This surgery is beneficial when a
patient suffers from disabling tremors that
interfere in his or her daily activities.
Pallidotomy:
Like in Thalamotomy, a tiny area called the
internal globus pallidus of the brain, is
destroyed using a similar method as the one used
above to relieve the patients from severe
dyskinesia.
Transplantation: Mid-brain
tissues of human foetuses are transplanted in
diseased portion of the brain. These foetal cells
produce dopamine leading to relieving the
patients of PD symptoms.
Deep Brain Stimulation:
Instead of destroying part of the brain
permanently by stereotaxic surgery a deep brain
stimulator is inserted to send rapid electrical
impulses to specific areas of the brain to treat
symptoms of tremor, rigidity and dyskinesias.
Radio surgery:
Radiosurgery is carried out by two main methods
namely gamma knife and linear accelerator (linac)
(14).
See Also:
Parkinson's
Disease: Introduction
Parkinson's
Disease: Forms
Parkinson's
Disease: Causes & Risk Factors
Parkinson's
Disease: Signs & Symptoms
Parkinson's
Disease: Stages
Parkinson's
Disease: Medical Tests & Diagnosis Methods
Parkinson's
Disease: Treatment
Article by Kona Vishnu, MS
Medical Writer,
OmniMedicalSearch.com
Sources
- Parkinson’s
Disease:
Overview,
Incidence and Prevalence, Risk Factors,
Neurology Channel, July 2007.
- Parkinson's
disease and Parkinsonism, What happens in
the brain of people with Parkinson's disease?
Brain & Spine Foundation Online, July 2005.
- Parkinson
Disease, emedicine, Robert A
Hauser, May 2007.
- Parkinson’s
Disease: An Overview, The
Parkinson’s Disease Foundation.
- Parkinson’s
Disease, Health encyclopaedia, NHS
Direct, September 2007.
- What
is Parkinson’s? Parkinson’s
Disease Society, August 2006.
- Parkinson’s
Disease - Forms, Neurology
Channel, July 2007.
- Parkinson's
Disease: Hope Through Research, National
Institute of Neurological Disorders and Stroke
(NINDS), August 2007.
- Parkinson's
disease - Causes, Mayoclinic.com, April
2007.
- Parkinson's
Disease Risk Factors, Parkinson's Disease
Information, Parkinsons.org, April 2007.
- Parkinson’s
Disease: Symptoms, The
Parkinson’s Disease Foundation.
- Parkinson’s
Disease:
Signs
and Symptoms, Diagnosis, Neurology
Channel, July 2007.
- Parkinson’s
Disease Guide: Exams and Tests, WebMD,
December 2006.
- Parkinson's
disease and Parkinsonism, A guide for
patients and carers, Surgery for Parkinson's
disease, Brain & Spine Foundation Online,
July 2005.
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