Parkinson’s disease (PD) is a type of movement disorder. It happens when nerve cells in the brain don’t produce enough of a brain chemical called dopamine. Sometimes it is genetic, but most cases do not seem to run in families. Exposure to chemicals in the environment might play a role.³

Symptoms begin gradually, often on one side of the body. Later they affect both sides. They include:

• Trembling of hands, arms, legs, jaw and face
• Stiffness of the arms, legs and trunk
• Slowness of movement
• Poor balance and coordination

As symptoms get worse, people with the disease may have trouble walking, talking, or doing simple tasks. They may also have problems such as depression, sleep problems, or trouble chewing, swallowing, or speaking.

Although there are general guidelines that doctors use to choose a treatment regimen, each person with Parkinson’s disease (PD) must be individually evaluated to determine which drug or combination of medications is best for them. For some, a “first choice” drug might be a form of levodopa, and for others, an initial prescription may be given for one of the dopamine agonists, an MAO inhibitor, or an anticholinergic.

The choice of medication depends on many variables including your symptoms, other existing health issues (and the medications being used to treat them) and age. Dosages vary greatly depending on a person’s needs and metabolism.

Since most Parkinson’s symptoms are caused by a lack of dopamine in the brain, many Parkinson’s drugs are aimed at either temporarily replenishing dopamine or mimicking the action of dopamine. These types of drugs are called dopaminergic medications. They generally help reduce muscle rigidity, improve speed and coordination of movement, and lessen tremor.

Always remember that medication is only part of the overall treatment plan for combatting PD. Talk to your doctor about available medications, but don’t forget exercise and complementary therapies.⁶

CAUTION

Parkinson’s medications may have interactions with certain foods, other medications, vitamins, herbal supplements, over-the-counter cols pills and other remedies. Anyone taking a PD medication should talk to their doctor and pharmacist about potential drug interactions. 

Exercise is an important part of healthy living for everyone. For those with Parkinson’s disease (PD), exercise is more than healthy — it is a vital component to maintaining balance, mobility and activities of daily living. Research shows that exercise and physical activity can not only maintain and improve mobility, flexibility and balance but also ease non-motor PD symptoms such as depression or constipation.

To help manage the symptoms of PD, your exercise program should include these key components:

1. Aerobic Activity
2. Strength Training
3. Balance, Agility & Multitasking
4. Flexibility

The four elements of exercises (above) are included in many types of exercise. Biking, running, Tai Chi, yoga, Pilates, dance, weight training, non-contact boxing, qi gong and more are included — all have positive effects on PD symptoms.⁷

People with Parkinson’s who engaged in at least 2.5 hours of exercise a week had a better quality of life than those who didn’t exercise at all or started exercising later.

In the first few years of living with Parkinson’s, your doctor will most likely utilize medications to help manage your symptoms. Medications often help minimize motor fluctuations (changes in the ability to move, often related to medication timing; also called “on-off” fluctuations). How-ever, there are occasions when medication is not enough and advanced treatment options are considered.

It is important to explore surgical options with your PD specialist if this is something you may consider. While surgery can be an effective treatment option for some PD symptoms, these tend to be the symptoms that previously improved while using levodopa. Surgery is often reserved for those who have optimized and exhausted medications for Parkinson’s tremor, or who experience profound motor fluctuations.

Currently, the two most common surgical treatments available for people living with PD are called deep brain stimulation (DBS) and Duopa™.⁸

Deep Brain Stimulation (DBS)

• DBS is a surgical procedure used to treat a variety of disabling neurological symptoms — most commonly the debilitating movement symptoms of Parkinson’s, such as tremor, stiffness, slowed movement, and slowed walking.
• DBS is not felt to damage healthy brain tissue or destroy nerve cells. Instead, the procedure is felt to interrupt problematic electrical signals from targeted areas in the brain.
• At present, the procedure is used only for people whose symptoms cannot be adequately controlled with medications.

Duopa

• Duopa™ therapy  is a form of  HYPERLINK “https://www.parkinson.org/living-with-parkinsons/prescription-medications/levodopa”carbidopa-levodopa delivered directly into the intestine in gel form rather than a pill. It is used to treat the same movement symptoms of Parkinson’s disease (PD) that carbidopa-levodopa does, but is designed to improve absorption and reduce  HYPERLINK “https://www.parkinson.org/library/fact-sheets/motor-fluctuations”“off” times (changes in movement abilities as a levodopa dose wanes) by delivering the drug directly to the small intestine.
• Before you can start Duopa, a surgery is necessary to make a small hole (called a “stoma”) in your abdomen to place a tube in your intestine. A pump then delivers Duopa directly to your intestine through this tube.