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Aug 06, 2006
Available medicines for Parkinson's Disease!
by SirGan
 It is well known that the Parkinson's disease is a specific movement disorder characterized by muscle rigidity, tremor and slowing of physical movement. Since it was discovered-experts are looking for the best possible medication or combination of medication that should relieve all the symptoms characteristic to this serious condition. Unfortunately, today, there is still no cure for Parkinson's disease. Treatment centers on the administration of medication to relieve symptoms. The treatment of this condition represents a significant challenge. What medications are the best today!? Mechanism of diseaseWhen we are talking about Parkinson disease, the well proven fact is that we are talking about damages of the dopamine pathways in our brain! There are four major dopamine pathways in the brain;
These pathways are associated with several functions such as volition and emotional responsiveness; desire, initiative, reward; sensory processes, maternal behavior. So, it is reasonable that reduction in dopamine along the non-striatal pathways is the likely explanation for much of the neuropsychiatric pathology associated with Parkinson's disease.
Symptoms of Parkinson’s diseaseBecause Parkinson disease affects primary movement, in most cases, we are talking about motor symptoms. However, there are many other non-motor symptoms such as disorders of mood, behavior, thinking, and sensation.
Risk factors for developing Parkinson’s disease
Although, many don’t think about this- age is still one of the main risk factors for Parkinson's disease. Therefore, the risk continues to increase with age.
Having one or more close relatives with Parkinson's increases the chances that you'll also develop the disease, although your risk is still less than 5 percent.
Men are more likely to develop Parkinson's disease than women are.
There is no doubt- exposure to herbicides and pesticides puts you at slightly increased risk of Parkinson's.
Several studies done recently have proven that reduced estrogen levels may increase the risk of developing Parkinson's disease. This means that menopausal women or the one with hysterectomy done may be at higher risk.
Treatment of Parkinson’s diseaseMedicationsAlthough there is still no cure for Parkinson’s disease, fact is that medications can help manage problems with walking, movement and tremor by increasing the brain's supply of dopamine. The medications used to treat Parkinson's disease include:
Since it was first discovered- Levodopa has been considered the gold standard drug therapy for Parkinson's disease. How come? Well, it is simple. Beside the fact that Levodopa is a natural substance found in plants and animals- it is also a precursor to brain’s neurotransmitter dopamine. This means that the chemical structures are similar but when injected into patient - it is being converted into dopamine by nerve cells in the brain. Logically- the increase in dopamine should relieve many of the disabling symptoms of Parkinson's disease. Patients are confused because they don’t know how come that the dopamine it self couldn’t be used! Well, the answer is simple- dopamine doesn't cross the body's blood-brain barrier which is made up from meshwork of tightly packed cells in the walls of the brain's capillaries that screen out certain substances. Levodopa, on the other hand, does cross this barrier.
What exactly is then the carbidopa (Sinemet)? Well, this is drug that causes more Levodopa to get to the brain and helps reduce some of the side effects of this therapy. That’s why it is given simultaneously with Levodopa! Every patient should also know that the length of time for which each dose is effective may begin to shorten leading to more frequent doses. Other side effects may include hallucinations and a drop in blood pressure when standing (orthostatic hypotension).
It is important thing to know that there is a class of medications called Dopamine Agonists which, unlike Levodopa, aren't changed into dopamine. Instead, their purpose is to mimic the effects of dopamine in the. The fact is also that Dopamine agonists are used both as adjuncts to Levodopa therapy and also initially in early Parkinson's disease, especially in younger adults. There are also some side effects that are common and they are almost the same to those of carbidopa-levodopa, although they're less likely to cause involuntary movements and more likely to cause hallucinations or sleepiness. These medications may also increase your risk of compulsive behaviors such as hypersexuality, compulsive gambling and compulsive overeating. Some of the medications from this class are: bromocriptine (Parlodel), pergolide (Permax), apomorphine (Apokyn), pramipexole (Mirapex) and ropinirole (Requip).
Although not too many people have heard about this drug, it is widely used with or without Levodopa therapy. What is its purpose? Well, it is proven that it helps prevent the breakdown of both naturally occurring dopamine and dopamine formed from Levodopa by inhibiting the activity of the enzyme monoamine oxidase B (MAO-B). But, like any other drug- it has its own limits! Latest studies have shown that Selegiline may delay the need for carbidopa-Levodopa for about a year, and when taken with carbidopa-Levodopa, may even enhance the drug's effectiveness.
These medications could be extremely important and helpful because they prolong the effect of carbidopa-Levodopa therapy. They are doing this by blocking an enzyme that breaks down dopamine. Some of these medications are: Tolcapone (Tasmar), Entacapone and many others…
Although now Anticholinergics aren’t so popular, these drugs were the main treatment for Parkinson's disease before the introduction of Levodopa. They were used to help control tremor in the early stages of the disease. Problem is that they were causing many possible side effects such as dry mouth, nausea, urine retention — especially in men with an enlarged prostate — and severe constipation. Anticholinergics can also cause mental problems, including memory loss, confusion and hallucinations. Some of the most commonly used are: trihexyphenidyl and benztropine (Cogentin), Benadryl, Amitriptyline …
Everyone knows that Amantadine is a famous anti-viral medication! Well, sometimes, doctors may prescribe this antiviral drug alone to provide short-term relief of mild, early-stage Parkinson's disease.
Not too many people know what coenzyme Q10 is? Well, this is one substance produced within small structures in cells called mitochondria. This substance is essential for the cells to work normally. One of these substances is coenzyme Q10, which transports electrons during cellular respiration- the process by which cells get their energy from oxygen. It is proven that people with Parkinson's disease tend to have low levels of coenzyme Q10. That’s why experts are saying that coenzyme Q10 supplements may slow the progression of early-stage Parkinson's disease.
Surgery is also an option!Proven fact is that neurosurgery is an option to treat Parkinson’s symptoms. Big problem is only that it isn't suitable for everyone. There are strict criteria and guidelines as to who can be a candidate for surgery, and this is something that only your doctor and you can decide.
The three commonly used forms of surgery are:
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