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Parkinson's Disease

Information from healthetopics.com to help you understand what Parkinson's Disease is and some of the drugs used to treat it.

Parkinson's Disease

 


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The content of this page was developed by licensed health professionals experienced in Parkinson's Disease. Parkinson's disease is a progressive condition affecting the nervous system. Parkinson's disease involves the loss of pigmented cells in the area of the brain that affects posture, muscle tone and voluntary smooth muscle activity. The disease will over a period of 10-25 years usually cause a degeneration severe enough to result in a significant loss of mobility often to the point of total immobility. In all but a few cases of Parkinson's disease there is no identifiable cause or even any obvious contributing factors.

The onset of Parkinson's disease is typically not before the age of 50 and in fact may appear much later although for most patients the disease is evident by age 70. The incidence of Parkinson's disease between women and men is almost identical. While the symptoms are certainly troublesome and can eventually result in the total loss of mobility, death as a direct result of Parkinson's disease is uncommon and the life expectancy for a Parkinson's patient has gradually increased to the point that it is very close to that of the population in general.

The most common and usually first noticeable symptom of Parkinson's disease is a tremor. The tremor is often observed in the hand and lower arm but tremors of the leg are also quite common. The tremor may appear as a fine tremor or more like finger movement as if rolling an invisible marble between the fingers. There is a large variation from patient to patient as to where in the body the tremor appears. For example head and neck movement is often observed yet sometimes it is almost totally absent. Early in the disease process the tremor often decreases substantially with muscle activity. For example the tremor will often decrease or appear to go away when a patient reaches for an object. Once the hand is back at rest the tremor will return. It is also unusual to see any tremors during sleep.

Because of the similarity to other diseases the rate of misdiagnosis among all of the conditions that cause tremors is quite high. This is especially true if the diagnosis is made by anyone other than a neurologist who is very familiar with this condition and the patients afflicted by it. Some of the diseases with similar symptoms are supranuclear palsy (PSP), Alzheimer's disease and essential tremor. Certain types of drugs can even cause Parkinson's like symptoms. While there is no specific test for Parkinson's disease, lab and other diagnostic testing may help in the diagnosis and also help to eliminate other possible diseases. You need to remember that while most patients with Parkinson's disease have tremors not every patient with a tremor has Parkinson's disease.

Some other common symptoms are muscle stiffness and ache, problems with balance, a shuffling type of step when walking, problems with swallowing and talking and postural changes. Although these are a few of the more common symptoms, many other symptoms are also possible and may in fact be a significant problem for a given patient.

Drugs are of primary importance in the therapy of Parkinson's disease. There are a number of drugs that can usually significantly decrease the symptoms of Parkinson's disease and this is the goal to reduce symptoms as there is no known cure. For most patients the drugs are not started early in the disease process but are held until the symptoms begin to affect daily activity. New studies are indicating that earlier treatment with certain drugs may slow the progression of the disease so we will probably be gin to see drug therapy used earlier in the disease process. Levodopa has been used for years to effectively treat the symptoms of Parkinson's disease but newer drugs and questions about negative effects from long term levodopa use have increased interest in and the use of newer drugs.

 

The following are the drugs commonly used in the treatment of Parkinson's disease listed by class.

Dopamine Prodrugs
Levodopa has been the primary drug used to treat Parkinson's disease since the late 60's. In the brain it is converted to dopamine the depletion of which results in the symptoms associated with the disease. Carbidopa is usually combined with carbidopa which decreases the amount of  levodopa that is converted to dopamine in other parts of the body leading to negative effects. Although levodopa can be amazingly beneficial, long term use can result major side effects such as restlessness, involuntary movement and confusion. Use of levodopa for a period greater than 5 years often produces a phenomenon referred to as the on-off effect in which a patient can rapidly switch between relative mobility  and near immobility.  Certain measures such as adding other drugs can help to suppress this on-off effect for a period of time but at some point this becomes impossible. While still used today other drugs have started to take the place of levodopa in many patients therapy. 

 

Dopamine Agonists
This class of drugs act like dopamine on the dopamine nerve receptors rather than actually turning into dopamine. They are often used in initial therapy then Sinemet is added as the disease progresses. Although free of the long term side effects of levodopa they often are more likely to cause short term side effects such as dizziness, nausea and confusion.

 

Monoamine Oxidase-B Inhibitors

 

Cathecol-O-methyltransferase (COMT) Inhibitors

 

Anticholinergics

 

Other Drugs

 

HELPFUL PARKINSON'S DISEASE LINKS:

National Parkinson's Foundation  The NPF have created an extensive web-site which includes information about Parkinson's disease, articles from their newsletters, on-lines tests for tremor etc.

Parkinson's Disease Foundation  PDF Celebrates its 50th with Unique Symposium on Parkinsons Disease Learn More About PDF's 50 Years of Serving the Parkinson's Community.

Michael J. Fox Foundation  The Michael J. Fox Foundation is dedicated to finding a cure for Parkinson's disease within the decade through an aggressively funded research agenda and to ensuring the development of improved therapies for those living with Parkinson's today.

 

For up to the minute news and information from around the world about Parkinson's Disease Visit NewsNow !

 

Although as accurate as possible, the information on this page may not relate to your particular medical condition and is not intended to be used in the diagnosis or treatment of any medical condition. Always refer to your healthcare provider before making any changes in your treatment plan. In addition any sites to which we link may or may not contain information appropriate to your medical condition.

 

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