Parkinson's Disease Patient Information Fact Sheet

Dopamine agonists stimulate the parts of the brain where dopamine acts. They can be taken alone or sometimes in combination with Sinemet. They produce fewer long-term side effects such as the on/off effect and are therefore often used in younger patients. Commonly prescribed examples are bromocriptine (Parlodel) and ropinirole (Requip). Apomorphine (Apokyn) is an injectable dopamine agonist that acts very quickly and can be used for people who experience extreme variations in mobility and need to be active at specific times. Cabergoline may be used in combination with levodopa, and pramipexole (Mirapex) may be used alone or in combination with levodopa. Amantadine (Symmetrel) promotes the release of dopamine and can help to reduce involuntary movements, but as it has only a mild effect is suitable for a smaller number of people.

Anticholinergics are used to correct the balance between acetylcholine and dopamine by blocking the action of acetylcholine. They are often used in younger people with milder symptoms. These include benzatropine (Cogentin), orphenadrine (Norflex), and trihexyphenidyl. COMT inhibitors are a newer class of drugs that block COMT, an enzyme that breaks down levodopa. This class includes entacapone (Comtan) and tolcapone (Tasmar). A combined product containing entacapone plus levodopa and carbidopa is also available (Stalevo).Selegiline (Eldepryl, Zelapar) slows the breakdown of dopamine and can increase the effectiveness of Sinemet. Rasagiline (Azilect) is another drug that works in a similar way.

The use of surgery to treat Parkinson's disease has been largely abandoned since the introduction of levodopa and other drugs. However, recently there has been renewed interest and new surgical techniques are currently being researched.

How does Parkinson's disease affect a person's life?
Most people with Parkinson's disease can lead a long and busy life. Life expectancy is the same as for people who do not have the disease. Despite problems with everyday life such as with writing, driving a car, mobility and communication difficulties, much help and support are available. Physical therapy, speech and language therapy and occupational therapy are all beneficial.

Self-help measures

• Keeping active can help to loosen stiff muscles and improve speech or posture.
• If you shuffle when walking, wear leather soled shoes to help you keep your balance.
• Try to keep your weight at a normal level as being overweight puts additional strain on your joints and may affect your mobility.
• Try to relieve symptoms of anxiety as this can make any tremor more severe and can also affect your sleep.

Further information
National Parkinson Foundation: http://www.parkinson.org

American Parkinson Disease Association: http://www.apdaparkinson.org

Michael J. Fox Foundation for Parkinson's Research: http://www.michaeljfox.org

Date last reviewed: July 2011