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Reduction of Levodopa Therapy

With ongoing Levodopa therapy for months or more commonly, a few years of treatment, two major types of motor complications tend to arise: motor fluctuations and dyskinesias. Motor fluctuations are variations in mobility associated with the effectiveness of levodopa when patients can tell when their medications kick in and wear off (the short duration response […]

The Role of Amantadine

Amantadine is also an older medication that was initially developed to help prevent influenza Type A. It was subsequently found to have a mild but definite effect on Parkinson’s without worsening typical symptoms. More recently, it has been found to be helpful in reducing levodopa-induced dyskinesias and now is predominantly used in advanced Parkinson’s disease […]

Surgical Therapies

Fortunately, there are more advanced options to consider if medical therapies do not seem to alleviate the symptoms of dyskinesia: Deep Brain Stimulation (DBS) Deep brain stimulation (DBS) should be considered for patients who have disabling motor fluctuations and dyskinesias despite optimal medication therapy or severe medication-refractory tremor.  Surgery should not be unnecessarily delayed when […]

Inadequately Controlled Motor Fluctuations

Overview As Parkinson’s disease progresses, the response to levodopa becomes more complex and medication beneficial effects begin to wear off between doses.   The variations in mobility such that patients can tell when their medications kick in and wear off are referred to as motor fluctuations.  Although motor fluctuations can be very frustrating and disabling, there […]

Medications for Parkinson’s Disease

The major classes of anti-Parkinson medication include carbidopa-levodopa (often referred to as Sinemet), catechol-o-methyltransferase inhibitors or COMT inhibitors, monoamine oxidase type B inhibitors, dopamine agonists, amantadine, and anticholinergics. Many of these medications are used in combinations although some of these may be used by themselves (in monotherapy) for treatment of symptoms of Parkinson’s disease. Levodopa […]

Deep Brain Stimulation (DBS)

Surgical treatment for Parkinson’s disease is indicated for patients who have disabling motor complications despite maximal drug therapy. This includes disabling levodopa-induced dyskinesias, medication-refractory disabling tremor or marked motor fluctuations in which there is variation in mobility from extremely immobile to good functioning. Surgical treatment is very helpful to treat motor complications, but with the […]

Nutritional Supplements (not proven scientifically)

There are a wide variety of nutritional supplements which are marketed to patients with Parkinson’s disease (PD). Unfortunately, the production of nutritional supplements is not regulated by the FDA. Side effects may occur and drug interactions are not uncommon. Many supplements have been studied in a careful and scientific manner to determine if they are […]

Exercise, Diet and Therapy for Parkinson’s Disease

Exercise has shown to be helpful for maintenance of good health for normal individuals in the population. It has especially been demonstrated to improve a variety of different features of Parkinson’s disease including gait, strength, balance, and speed of movement. In the general population including patients with Parkinson’s disease, cardiovascular exercise improves cognitive function, mood, sleep, […]

Non-Motor Symptoms of Parkinson’s Disease

Often non-motor symptoms of Parkinson’s Disease can be overlooked and thought to be unassociated with PD, especially in the early stages of the disease. However, there are a variety of non-motor symptoms that can affect up to 50% of the PD population. Two of the major non-motor symptoms include cognitive changes and mood disorders. Cognitive […]

Overview of Motor Symptoms

The most common motor symptoms of PD include tremor (occurring at rest), slowness of movements (bradykinesia), rigidity of movements in the limbs, trunk, and neck, and reduced balance. PD is a progressive neurological condition so symptoms, including motor symptoms, worsen over time. Tremor – Around 80% of PD patients have a tremor or will develop one. […]