What medications are commonly prescribed for Parkinson’s disease?

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What medications are commonly prescribed for Parkinson’s disease?

Several medications are commonly prescribed to manage the symptoms of Parkinson’s disease. These medications primarily aim to address the motor symptoms of the disease, such as tremors, stiffness, and bradykinesia (slowness of movement). Here are some of the most commonly used medications:

1. Levodopa/Carbidopa (Sinemet)

Levodopa: The most effective medication for Parkinson’s disease, levodopa is converted into dopamine in the brain, helping to replenish the low levels of dopamine that cause Parkinson’s symptoms.
Carbidopa: Often combined with levodopa to prevent it from being converted into dopamine outside the brain, which reduces side effects like nausea and increases the amount of levodopa that reaches the brain.

2. Dopamine Agonists

Examples: Pramipexole (Mirapex), Ropinirole (Requip), and Rotigotine (Neupro, a skin patch).
Function: Dopamine agonists mimic the effects of dopamine in the brain, stimulating dopamine receptors directly. They are often used in the early stages of Parkinson’s or in combination with levodopa in more advanced stages.
Side Effects: Can include hallucinations, sleep disturbances, and compulsive behaviors.

3. MAO-B Inhibitors

Examples: Selegiline (Eldepryl, Zelapar), Rasagiline (Azilect), and Safinamide (Xadago).
Function: These medications inhibit the enzyme monoamine oxidase B (MAO-B), which breaks down dopamine in the brain. By slowing down this process, MAO-B inhibitors help increase and prolong the effect of dopamine.
Use: They can be used alone in early-stage Parkinson’s or in combination with other medications in later stages.

4. COMT Inhibitors

Examples: Entacapone (Comtan), Tolcapone (Tasmar), and Opicapone (Ongentys).
Function: These drugs inhibit the enzyme catechol-O-methyltransferase (COMT), which breaks down levodopa. COMT inhibitors help extend the effect of levodopa, reducing “off” periods when the medication’s effects wear off.
Side Effects: May include diarrhea, and in the case of tolcapone, potential liver toxicity.

5. Amantadine

Function: Originally used as an antiviral drug, amantadine has been found to help reduce Parkinson’s symptoms, particularly dyskinesia (involuntary movements) caused by long-term levodopa use.
Side Effects: Can include hallucinations, confusion, and ankle swelling.

6. Anticholinergics

Examples: Benztropine (Cogentin) and Trihexyphenidyl.
Function: These medications help reduce tremors and muscle rigidity by blocking the action of acetylcholine, a neurotransmitter in the brain.
Use: Often used in younger patients with predominant tremor symptoms, but less commonly prescribed due to side effects like memory problems, confusion, and dry mouth.

7. Newer Treatments and Adjuncts

Examples: Istradefylline (Nourianz), an adenosine receptor antagonist, is a newer medication used as an add-on therapy to reduce “off” episodes in patients taking levodopa.
Investigational Drugs: Tavapadon is an example of a drug currently in late-stage clinical trials that aims to provide motor benefits with fewer side effects related to dopamine receptor overactivity.

These medications are often used in combination to manage the different symptoms of Parkinson’s disease and to address the challenges that arise as the disease progresses. The choice of medication, dosage, and timing is tailored to the individual needs of the patient and often requires adjustments over time to maintain the best possible quality of life (Parkinson’s News Today) .

Jodi Knapp