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Parkinson's disease - treatment
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Parkinson’s disease cannot be cured but it can be managed. Support and treatment can help manage the symptoms of Parkinson’s disease. The main method of treatment is medication, which aims to alleviate the symptoms. Many kinds of medications are available.
Parkinson’s disease is a progressive neurological condition and is often referred to as a movement disorder. The symptoms include tremor, rigidity, slowness and impaired movement. With a combination of medication and multidisciplinary support, people with Parkinson’s can live independent and productive lives.
No two people have exactly the same Parkinson’s and no two people will have exactly the same treatment. Your doctor or neurologist can help you decide which treatments to use.
Medication
Symptoms of Parkinson’s disease result from the progressive degeneration of nerve cells in the middle area of the brain. This causes a deficiency in the availability of dopamine, which is necessary for smooth and controlled movements.
Most Parkinson’s medications fit into one of the following broad categories:
- Levodopa – dopamine replacement therapy.
- Dopamine agonists – mimic the action of dopamine.
- COMT inhibitors – used along with levodopa. This medication blocks an enzyme known as COMT to prevent levodopa breaking down in the intestine and to allow more of it to reach the brain.
- Anticholinergics – block the effect of another brain chemical (a neurotransmitter called acetylcholine) to re-balance its levels with dopamine.
- Amantadine – has anticholinergic properties and enhances dopamine transmission.
- MAO type B inhibitors – prevents the metabolism of dopamine within the brain.
Talk to your doctor about your treatment
It is important to see a neurologist or a doctor who has experience in assisting people living with Parkinson’s disease. These are the best people to help you decide which treatments to use.
There is no ‘best’ drug treatment for Parkinson’s. Each person has different symptoms, disease progression, lifestyle and physical tolerances. All of these factors will affect the timing, type, dose and combinations of medication. As the disease progresses, your individual medication program will need to be reviewed and altered.
It is very important to take your medication at the recommended time and on time every day, whether you are at home, at work, in hospital or in a nursing home. Medications taken late can severely hamper the movements of people living with Parkinson’s.
How long does the medication last?
Medication will help to elevate symptoms but will not alter the progression of the symptoms over time. Over time, you may experience problems with your medication wearing off and may need to try different drug regimes to get the most benefit.
Seeing a neurologist regularly will help you to make sure you are getting the best possible medication management. A neurologist will manage your doses and any necessary adjustments. This is important as side effects can be a problem when on large doses.
Multidisciplinary support can help
Early access to a multidisciplinary support team is important. These teams may include doctors, physiotherapists, occupational therapists, speech therapists, dietitians, social workers and specialist nurses. Members of the team assess the person with Parkinson’s and identify any potential difficulties.
There are a limited number of multidisciplinary teams in Victoria that specialise in Parkinson’s management.
Surgery is an option
Neurosurgery (brain surgery) is an option to treat Parkinson’s symptoms, but it is not 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:
- Thalamotomy – a lesion (cut) is placed on part of the brain to alleviate some forms of tremor.
- Pallidotomy – a lesion is placed on a different part of the brain to alleviate dyskinesias (wriggling movements).
- Deep brain stimulation – an electronic deep brain stimulator is placed in the brain to control specific symptoms. The electrical impulse creates a lesion, which blocks abnormal nerve signals and reduces the targeted symptom. This device is sometimes called a brain pacemaker.
Help for carers
Being a carer can be difficult. A wide range of agencies can provide help and support. These include:
- Parkinson’s Victoria Tel. 1800 644 189
- Carers Victoria Tel. 1800 242 636
- BrainLink Tel. 1800 677 579
Support includes counselling, carer education programs, information on a variety of issues and support groups.
Where to get help
- Your doctor, who can refer you to a neurologist
- A neurologist or your local doctor can also arrange a referral to a movement disorders clinic
- Kingston Movement Disorder Clinic Tel. (03) 9265 1411
- Wantirna Health (Wantirna) Tel. (03) 9955 1229
- Rosebud Rehabilitation Unit (Rosebud) Tel. (03) 5981 2166
- Elsternwick Private (Elsternwick) Tel. (03) 9528 6855
- St John of God, Nepean Rehabilitation (Frankston) Tel. (03) 9788 3330
Things to remember
- A neurologist is the best person to see if you have Parkinson’s disease – your GP can arrange this.
- It is important to discuss your medication issues with your treating health professionals.
- No two people have exactly the same Parkinson’s and no two people will have exactly the same treatment.
- Good management is a combination of medication and multidisciplinary support.
- Medication continues to be effective throughout the condition’s progression; however, doses will need to be adjusted as symptoms change.
You might also be interested in:
Dementia explained.
Nervous system.
Parkinson's disease.
Parkinson's disease and constipation.
Parkinson's disease and exercise.
Parkinson's disease and going to hospital.
Parkinson's disease and sexual issues.
Want to know more?
Go to More information for support groups, related links and references.
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This page has been produced in consultation with, and approved by:
Parkinson's Victoria
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Copyight © 1999/2009 State of Victoria. Reproduced from the Better Health Channel (www.betterhealth.vic.gov.au) at no cost with permission of the Victorian Minister for Health. Unauthorised reproduction and other uses comprised in the copyright are prohibited without permission.
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This Better Health Channel fact sheet has passed through a rigorous approval process. For the latest updates and more information visit www.betterhealth.vic.gov.au.
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Last updated: April 2009
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Parkinson's disease is currently an incurable condition, but symptoms can be treated with a range of medications. Support is the best form of management, when used in conjunction with medication. Neurosurgery to alleviate symptoms is also an option for some people. ..
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