Treatment
Of Parkinsons DiseaseBefore embarking on drug treatment of Parkinson's
disease I suggest you watch
this YOU TUBE video. This video shows how by wearing special goggles
for half an hour daily the brain can produce new pathways that circumvent the
freezing episodes and help to normalize gait. Once learnt, it becomes a permanent
cure for many patients. IK say this, because many of the medications below can
have significant side-effects that can lead to a worsening of the condition. Another
fact that is often overlooked is that many patients can be made better by detoxification
methods that anti-aging physicians utilize. Good nutrition and proper
supplements are important as well. All of this is discussed under this
link in detail. Finally, before embarking in drug treatment for Parkinson's
disease I would suggest you first read this hormone
replacement chapter. I say this, because many patients are deficient in
hormones and can be improved or cured by bio-identical hormone replacement. Generally
speaking it is always better to use substances that the body knows than attempting
to outsmart nature by introducing any of the artificial chemicals below. Having
said this, there likely still is a place for using these agents judiciously. Levodopa:
This medication is a dopamine drug (it is a precursor of it) and is taken up in
the basal ganglia and can be used to replace the missing neurotransmitter. It
is most helpful for rigidity and slow muscle motions. Levodopa is usually combined
with another medication, carbidopa, which decreases the breakdown of levodopa
and thus saves medication and reduces side-effects. This levodopa/carbidopa
combination comes in different strength combinations (brand names: Sinemet and
SinemetCR). Side-effects are flushing, nausea and palpitations. Your neurologist
or physician can advise you about other details regarding this drug, including
the "on-off effect" after several years of usage, when the medication
might have to be taken in smaller steps more often or be combined with selegiline. Bromocriptine
(brand name: Parlodel) and pergolide mesylate (brand name: Permax) are
ergot alkaloids, which activate dopamine receptors directly in the basal ganglia.
This medication ends to still work even when levodopa wears off in later years
of treatment. Some of the side-effects are low blood pressure with fainting when
suddenly standing up(orthostatic hypotension), dizziness, nausea, delirium, even
psychosis. Selegiline (brand names: Eldepryl, Novo-Selegiline)
works by inhibiting one of the two major enzymes that breaks down dopamine in
the brain. It is called a monoamine oxidase type B inhibitor, or for short: MAO-B
inhibitor. The end result is an increase in available
dopamine in the basal ganglia. It would help then to prolong the action of Sinemet
when this is given at the same time. Selegiline has hardly any side-effects and
can, when given initially for mild Parkinson disease, postpone the need for levodopa
medication for about 1 year. It also may slow down the degenerative effect of
Parkinson disease for some time. However, when given together with levodopa, the
levodopa side effects tend to be more pronounced and the dose of levodopa may
have to be reduced. However, any change of dosage should only be done under supervision
of your doctor.
Amantadine
(brand names: Endantadine, Symmetrel, Symadine) seems to release domine
from brain nerve endings making it more available to dopaminergic receptors thus
alleviating the symptoms of Parkinson disease. The antiviral activity
against the Asian(A2) influenza is an entirely different mechanism. This medicine
is usually used for mild Parkinson disease in the beginning, but often combined
with levodopa in late disease. By itself it tends to lose effectiveness after
a few months of usage. Some of the side effects are: swelling of the lower legs
and bluish discoloration of the skin, confusion, rarely depression with suicidal
behavior and also rarely neuroleptic malignant syndrome when the medication is
suddenly stopped. Ask your physician about the exact dosage instructions and report
any symptoms to your physician. Anticholinergic medications:
Occasionally these medications are used in mild Parkinson disease cases in the
beginning, however, most of the time they are used in combination with levodopa.
The most commonly used anticholinergic drugs are perhaps benztropine
(brand name: Cogentin) and trihexyphenidyl (brand name:
Trihexane, Trihexy). Benztropine is a powerful anticholinergic agent relieving
muscle tremor and rigidity. As these are the main problems with Parkinson disease,
symptoms such as frozen face muscles, abnormal posture and gait all return to
normal. Speech becomes freer, sustained rigidity, muscle discomfort and restlessness
during sleep are also improved. Anticholinergic medication is also useful in drug-induced
Parkinson disease from medications such as antipsychotics where swallowing problems,
lockjaw, restlessness urinary frequency and others can be a problem. However,
like any other medication, these medicines have side effects like nausea, confusion,
hallucination, dry mouth, constipation and others. Ask your physician for more
details. ADVERTISEMENT
Antihistamines
with anticholinergic action such as diphenhydramine
(brand names: Benadryl, Allerdryl, Allernix, Nytol) and orphenadrine
(brand names: Disipal, Norflex) are useful for treating tremor and
muscle spasm. Side effects are a dry mouth and drowsiness. Anticholinergic antidepressants
such as amitriptylene (brand names: Elavil, Endep) are useful in conjunction with
levodopa to regain mobility, but also to treat depression, which is often associated
with Parkinson disease. Side effects are usually a dry mouth, constipation and
drowsiness, but when given at bedtime, the drowsiness often is not a big problem.
Propranolol (brand name: Inderal) can be very useful in
treating those patients with Parkinson disease, where the tremor in the extremities
gets worse with activity or intention to get moving (called "intention tremor").
As mentioned earlier, normally the tremor improves with muscle activity. These
are the patients who have a hard time to hold on to a cup of coffee or have gait
problems when they walk or get ready to walk. Inderal is often very helpful in
these patients. Side effects: patients with asthma or chronic bronchitis cannot
take this medication because of a worsening of bronchospasm on this medication.
Also, it is contraindicated for congestive heart failure patients. Ask your doctor,
if you think you could benefit from it. | 
