Parkinson’s Disease Treatment, Care & Medications

While there is currently no cure for Parkinson’s disease, there are various treatments and medication available to relieve the symptoms and improve your quality of life.

by Elaine Francis, R.N.

While there is currently no cure for Parkinson’s disease, there are various treatments and medication available to relieve the symptoms of Parkinson’s disease and improve your quality of life.

What is Parkinson’s Disease?

Parkinson’s Disease (PD) is a neurological movement disorder — this means that it is a condition that affects our nerves. People with PD begin to develop damage to some of the nerve cells in the brain, which reduces the amount of dopamine — the chemical which helps transmit messages through the nerves. It particularly affects the part of the brain which controls movement. 

PD is a degenerative condition, which means that it gradually gets worse over time. For some people, the progression of the disease is slow, but for others, symptoms get worse quickly.

Is there a cure for Parkinson’s Disease?

There is currently no cure for Parkinson’s disease, but treatments and therapies are available to help manage the symptoms and even slow the progression of the disease. Research into treatments for PD are always ongoing, and treatment options are improving.

Treatment for Parkinson’s Disease

The most effective medical treatments for Parkinson’s disease are a combination of medications that work by increasing the way the nerves react to dopamine. Having the right support with the physical and functional aspects of having PD are an essential part of the treatment too. Seemingly simple techniques and lifestyle changes, including physiotherapy, exercise, and diet, can help slow the disease’s progression.

Medication for Parkinson’s Disease

Medications used in PD commonly come as a combined medication, where two different drugs complement each other for the management of the condition.

Some of the most common medications used in Parkinson’s Disease are:

  • Carbidopa-Levodopa is usually the most effective medication commonly used in PD. Levodopa is a chemical that is converted into dopamine in the body, increasing the amount of dopamine in the brain and helping make those connections between nerve cells. It is given with carbidopa which ensures that the conversion happens within the brain itself. This combination drug is usually given as a tablet or capsule. The main effects of these drugs only last a few hours, so getting the timing right is important.
  • Dopamine agonists, such as ropinirole or rotigotine, acts to mimic the dopamine in the brain. Rotigotine comes in the form of a patch that is worn on the skin. This can be helpful for people who are not able to take tablets or stick to the strict timetable of oral medications.
  • MAO-B inhibitors, such as rasagiline or selegiline, is a natural enzyme that breaks down dopamine in the body. Normally, this is a normal and natural process, but when dopamine levels are reduced, such as in people with Parkinson’s disease, inhibiting the MAO-B helps to protect dopamine.
  • Amantadine helps with mild symptoms, usually in the earlier stages of Parkinson’s, or in combination with other medications as PD progresses.

As some PD medications are short-acting, it is highly important to take them at the right times with the same interval in between doses. Getting the right type, dose, and timing of PD medications can take a little trial and error, and no two people experience Parkinson’s disease in quite the same way.

Surgery for Parkinson’s Disease

Occasionally, a surgical technique called deep brain stimulation can be used for people with PD. This involves placing some electrodes that stimulate the parts of the brain affected by Parkinson’s. They are attached by fine wires to a small battery and control box implanted under the skin of the chest, a lot like a cardiac pacemaker. Deep brain stimulation can have a positive effect on some of the involuntary movements people with PD experience but does not seem to improve the non-movement symptoms, gait or balance.

Managing Parkinson’s Disease

Managing Parkinson’s disease day-to-day involves a combination of approaches to control its symptoms and adjust your lifestyle to meet any new needs and changing abilities.

Physiotherapy for Parkinson’s Disease

Maintaining strength, motor skills and balance in Parkinson’s can make a huge difference to the symptoms, progression, and experience of the disease. Physiotherapists can work with people with Parkinson’s to create personalised exercise plans that help to maintain functional ability. They can also recommend and fit mobility aids, such as walking sticks or frames, or sometimes braces or orthotics to help with gait and balance.

Occupational Therapy in Parkinson’s Disease

Occupational therapists (OTs) help individuals with PD continue functioning and living independently. They do so by introducing a variety of functional exercises and strategies to manage one’s evolving needs. OTs also assess a person’s home or work environment and recommend suitable modifications and supply practical aids to improve mobility and overcome barriers to independence. 

Equipment that an OT may recommend and provide to help with changes to gait and balance include the installation of grab rails, specially designed baths, showers, or wet rooms. An occupational therapist may also be involved in assessing a person’s care needs when setting up a formal care package.

Speech and Language Therapy in Parkinson’s Disease

Speech and Language Therapists help people with barriers to communication, which can become more common in the later stages of Parkinson’s disease. Speech and Language specialists also help manage the swallowing difficulties that can arise from reduced movement control.

Diet and Nutrition in Parkinson’s Disease

Following a careful diet can help reduce some of the symptoms or side effects of Parkinson’s.

Some people find that they lose too much weight when they have Parkinson’s, which can be due to problems chewing and swallowing, or trouble with shopping, cooking, and eating independently. On the other hand, others may gain weight as exercise becomes harder due to the effects of PD.

Constipation is a common problem for people with Parkinson’s Disease; reduced exercise, less movement through the bowel, and altered eating habits all contribute to constipation. It can usually be managed through a healthy diet and simple over-the-counter stool softeners or laxatives. A general practitioner can help if it becomes a serious concern.

As Parkinson’s disease progresses, swallowing problems become more common. Support from speech and language therapists can help with techniques and adjusting the diet so that food and drinks are manageable. With shaking hands and reduced movement control, it becomes harder and harder to feed yourself, so family or formal care support often becomes essential over time. 

Other Symptoms of Parkinson’s Disease

As Parkinson’s disease can affect so many aspects of a person’s life, good management takes input from a broad multidisciplinary team. Managing the most significant, immediate symptoms of the disease is important, but recognising that everyone’s experience of Parkinson’s is different is also essential. Symptoms of Parkinson’s, and side effects of PD treatments, can create unique challenges which all need to be managed carefully.

Besides the more widely known symptoms such as tremors and rigidity, other symptoms of Parkinson’s disease include:

  • Incontinence: One of the effects of reduced transmission along nerves in the brain is that the sensation of bladder or bowel fullness can be missed, so sometimes people with PD don’t realise that they need the loo until it’s too late to get there on time. This can cause embarrassment and negative self-image — people with continence problems often worry about getting outside where they might not be within easy reach of a toilet. It also poses a physical risk of damage to the skin from moisture and an increased risk of falls. Managing continence with pads, medications, exercises, and changes to routine can help. When necessary, nurses and caregivers can support people with continence management.
  • Sexual Dysfunction: Problems getting an erection are common in men with PD. Erectile dysfunction can be a difficult subject to talk about, but keep in mind that general practitioners have heard it all before and are always happy to be consulted. Talking about sex — and especially sexual problems — is thankfully becoming less taboo for many people. Men and women alike might find the quality of their sex life changes as their mobility, dexterity and energy levels change; speaking to a doctor can help as there are options for support, and it’s okay to want to continue with a fulfilling sex life.  
  • Drooling: It can be difficult to control saliva when you have Parkinson’s, and it is quite common to drool or dribble. Medications can help, and some doctors may also give specialised botox injections that control the production of saliva.
  • Sweating: Parkinson’s can cause people to sweat more. This can become a real problem for some people, but can usually be controlled by normal PD medications – excess sweating can be a sign that your medication regime needs tweaking.
  • Depression: Unfortunately, depression is quite common in Parkinson’s disease, for a variety of reasons. Depression can be a direct result of the changes in life and health that Parkinson’s brings, and is also thought to occur because of some of the physical and chemical changes in the brain. Living with depression can be overwhelming and debilitating, and it’s absolutely essential that you seek professional help. Support and treatment can save lives.
  • Dementia: Not everyone with Parkinson’s disease develops dementia, but there is a form of dementia that is linked closely to PD. Parkinson’s dementia happens when the changes that are happening in the brain begin to affect the areas of the brain responsible for memory. Like other aspects of Parkinson’s disease, Parkinson’s dementia gets worse over time. As memory problems progress alongside other symptoms of Parkinson’s, most people need more and more support with their normal activities of daily living. Family support can go a long way but a formal care package with trained support workers is sometimes needed.

Living with Parkinson’s Disease

Medical management and support from healthcare professionals can greatly impact a person’s experience with PD. 

As Parkinson’s disease progresses, a person’s needs change, and they may become less able to do the things they used to do. This can include getting washed and dressed, getting to the toilet, shopping, cooking, and feeding themselves. Sometimes family are able to stay closely involved in the care of a person with Parkinson’s disease, but family may be unable to provide all the care someone needs, especially as the disease progresses. 

If being able to get out and about independently is an issue or a person with Parkinson’s needs an increasing level of help with activities of daily living, having a formal care package can help to promote independence. With experienced carers helping make up any new limits in self-care, it’s possible to keep living the life you want for as long as possible. 

The kind of all-round Parkinson’s care package provided by professional nurses and carers can help a person with Parkinson’s stay safe and cared for in their own home, help them get out and continue the kind of lifestyle they want, and enable a family to maintain their usual kind of relationship with each other.

References
  1. Benabid, A. L. (2003). Deep brain stimulation for Parkinson’s disease. Current opinion in neurobiology, 13(6), 696-706. https://doi.org/10.1016/j.conb.2003.11.001
  2. Redecker, C., Bilsing, A., Csoti, I., Fogel, W., Ebersbach, G., Hauptmann, B., … & Müngersdorf, M. (2014). Physiotherapy in Parkinson’s disease patients: recommendations for clinical practice. Basal Ganglia, 4(1), 35-38. https://doi.org/10.1016/j.baga.2014.03.001
  3. Alcalay, R. N., Gu, Y., Mejia‐Santana, H., Cote, L., Marder, K. S., & Scarmeas, N. (2012). The association between Mediterranean diet adherence and Parkinson’s disease. Movement Disorders, 27(6), 771-774. https://doi.org/10.1002/mds.24918
  4. Srivanitchapoom, P., Pandey, S., & Hallett, M. (2014). Drooling in Parkinson’s disease: a review. Parkinsonism & related disorders, 20(11), 1109-1118. https://doi.org/10.1016/j.parkreldis.2014.08.013
  5. Lyons, K. E., & Pahwa, R. (2011). The impact and management of nonmotor symptoms of Parkinson’s disease. American journal of managed care, 17(12), S308. http://ajmc.s3.amazonaws.com/_media/_pdf/0dfca238c71b093013ffb87100731571.pdf
  6. Bronner, G., & Vodušek, D. B. (2011). Management of sexual dysfunction in Parkinson’s disease. Therapeutic advances in neurological disorders, 4(6), 375–383. https://doi.org/10.1177/1756285611411504
  7. Schrag, A.; Jahanshahi, M.; Quinn, N.P.; (2001) What contributes to depression in Parkinson’s disease? Psychological Medicine https://doi.org/10.1017/S0033291799003141
  8. Balash, Y., Peretz, C. H., Leibovich, G., Herman, T., Hausdorff, J. M., & Giladi, N. (2005). Falls in outpatients with Parkinson’s disease. Journal of neurology, 252(11), 1310-1315. https://doi.org/10.1007/s00415-005-0855-3

About the Writer
Elaine Francis, R.N.
Elaine Francis is a registered nurse with 17 years’ experience in healthcare. She turned to writing to follow her passion for realistic medical communication. She loves translating medical jargon into accessible language for the people who need to understand it most. When she’s not writing or working on a busy cardiology unit, she spends her time telling her children to hurry up.
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