Conventional Treatment for Parkinson's Disease
By Joel Fuhrman, M.D. www.drfuhrman.com
Modest Suppression Of Symptoms Is The Best You Can Hope For!
Conventional treatment of Parkinson’s disease (PD) includes medications that ease the movement-related symptoms of the disease by increasing levels of dopamine in the brain. Sometimes anti-cholinergic drugs, which increase levels of acetylcholine in the brain, are used as well. Unfortunately, none of these medications has been shown to slow the progression of the disease. Often, the dose of medication will need to be increased over time, or different medications will need to be added in order to manage symptoms. 21 Levodopa, a drug that is converted to dopamine in the brain, is the oldest and most effective treatment for Parkinson’s symptoms.
Problems With Levodopa
The problem with levodopa is that it accelerates the loss of the dopamine nerve terminals over the long term. This can cause a very gradual acceleration of the progression of the disease, necessitating periodic increases in the dosage to achieve the same results. In the majority of patients, the chronic intermittent stimulation from dopamine-producing drugs causes changes in the brain that within five years of treatment will worsen the dyskinesia (difficult or distorted voluntary movements). The duration and dose of levodopa treatment are risk factors for developing dyskinesia.
Strategies to improve dyskinesia involve reduced dosage of levodopa, neurosurgery, addition of antidyskinesia drugs, or addition of alternative PD medications called dopamine agonists. Dopamine agonists are designed to deliver dopamine in a more continuous fashion, but patients taking them are still at risk for dyskinesia.
Additional side effects of levodopa and dopamine agonists include nausea, vomiting, loss of effect of the medication, sleep disturbances, and impulsive behaviors. The neurosurgical procedure for PD is called deep brain stimulation. An electrode is inserted into the brain and programmed to deliver a steady frequency of electrical pulses in order to counteract the abnormal brain activity associated with PD.22 This surgery may decrease the dose of medication needed, but, like the medication, it only suppresses symptoms and does not slow or halt progression of PD.21
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