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Parkinson’s disease is a common late-age neurodegenerative disorder that severely limits a abilities and independence. Despite some recent progress, the treatments for this condition remain mostly symptomatic and supportive.

Like with all other neurodegenerative disorders, the Parkinson’s disease diagnosis spells troubles for both patients and their relatives. The disease is caused by the degeneration of certain cells in the brain that rely on dopamine as a neuromediator. This degeneration results in a gradual development of various movement-related dysfunctions (shaking, rigidity, problems with walking and gaits etc.) which can further be complemented by dementia, behavioral changes and depression at later stages of the disease.

The patients lose their independence and are no longer as physically active and productive as they would have liked to be. The symptoms of Parkinson’s disease develop over the years, and aging increases the chances of developing this disease. But what is more disconcerting is that managing this disease is extremely challenging.

The Challenges Of Managing Parkinson's Disease

Here is the hard truth: there is no cure for Parkinson’s disease at the present time.

All available treatment methods for Parkinson’s disease are symptomatic, but their efficacy is severely limited, and they hardly work for individuals diagnosed with advanced-stage condition. These are the three groups of medicines commonly prescribed to Parkinson’s disease patients in the various stages of the disease: drugs that increase the level of dopamine, those that work on other neurotransmitters, and those that control the non-motor symptoms of the disease.  

Deep brain stimulation is a surgical method to manage the disease, but not everybody can fulfill the stringent criteria laid down for those who want to undergo the procedure. Parkinson’s disease is a progressive neurodegenerative disorder that is believed to be triggered by a complex interplay of genetic and environmental factors. So researchers are exploring the scope of cell- and gene-based therapies to manage the disease. Some of these therapies have shown promising results, but they are still in the infancy.  

The need of the hour is to develop treatment methods that both provide symptomatic relief and also stall the progress of the disease.

Levodopa is currently the main drug for managing the symptoms of Parkinson’s disease.

The symptoms of Parkinson’s disease are usually triggered by low or failing levels of dopamine, a neurotransmitter. Administration of levodopa (L-dopa) pills or those that increase the levels of dopamine is one of the most effective of all management strategies for the disease right now in practice.  

Levodopa has been shown to be effective in managing the symptoms and slowing the progress of Parkinson’s disease during the first few years of administration. However, this drug begins to lose its efficacy after several years of usage. Prolonged use also gives rise to several complications like abnormal or impaired voluntary movements (dyskinesias) and fluctuations in motor functionalities. These complications show up in 50% and 80% of Parkinson’s disease patients after using L-dopa for 5 years and 10 years, respectively.

So it is evident that L-dopa is not the lasting solution for treating the patients with Parkinson’s disease. What is more, this group of drugs works only to enhance dopamine levels. But the symptoms of Parkinson’s disease can be triggered or aggravated by abnormalities in the levels of other neurotransmitters like acetylcholine and glutamate and amino acids like N-methyl-D-aspartate. L-dopa has no action on these neuronal elements.   

Continue reading after recommendations

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  • Wood, L. et al. (2010). Clinical review of treatment options for select nonmotor symptoms of Parkinson's disease. The American Journal of Geriatric Pharmacotherapy 8(4). p.294-315.Photo courtesy of Cjalallian via Flickr: www.flickr.com/photos/cjalallian/4395751337
  • Photo courtesy of Enzymlogic via Flickr: www.flickr.com/photos/101755654@N08/11877025676

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