What Treatments Are Available?

There is currently no treatment that has been shown to halt, slow or reverse the progress of Parkinson's disease. While the disease itself is currently incurable, there are many treatment options that can help ease the symptoms and lessen their impact on your life. Which, if any, of these treatments is right in your case is between you and your doctor.

No Treatment
In the earliest stages of the disease, many people with Parkinson's have only very mild symptoms that need no treatment at all. Some doctors, however, will recommend certain supplements or changes to activity and diet that may help protect the brain from further damage.

Neuroprotective L-dopa in Early Stages
Because of complications that happen with the long-term usage of levodopa, a precursor to dopamine, most doctors traditionally held off prescribing L-dopa until the symptoms of Parkinson's were severe enough to restrict a patient's activities. Some doctors now believe that treatment with L-dopa in the earlier stages of the disease may slow its progress and confer some protection on the cells in the substantia nigra that produce dopamine.

Medication
Traditional treatment for Parkinson's disease focuses on replacing the dopamine that the body is not supplying from other sources. The medications used for that purpose include pramipexole, ropinirole, pergolide or bromocriptine, dopamine agonists that mimic the effects of dopamine, and L-dopa (levodopa, Sinemet), which the body can convert into dopamine. One of the problems with L-dopa is that the body converts it to dopamine before it reaches the brain, and metabolizes it. For that reason, L-dopa is often given along with a dopamine inhibitor which prevents the body from converting it before it crosses the blood brain barrier.
Surgical Treatments
There are several surgical treatments which can eliminate or reduce the symptoms of Parkinson's disease. These include procedures that destroy small clusters of cells in different areas of the brain which cause those tremors. One of the newer surgical treatments for Parkinson's disease is Deep Brain Stimulation, in which surgeons implant electrodes in different areas of the brain. The electrodes are then stimulated via an implant similar to a pacemaker.

Still in the experimental stages are two procedures which may actually hold the best hope for a cure for Parkinson's disease - the implantation of genetically engineered cells that will make dopamine, or of stem cells which will grow into dopamine producing cells.

Auxiliary Treatments
In addition to treatments that directly affect the major symptoms of Parkinson's disease, people with Parkinson's often benefit from other related therapies and treatments. Regular physical exercise helps patients to maintain more physical ability and balance later into the course of the disease. Some doctors advocate supplementing the diet with folic acid and other supplements to contribute to overall health and confer some protection to the cells of the brain through antioxidants and nutritional pathways. Many people with Parkinson's also find muscle massage therapy and other alternative therapies to be helpful, particularly in the early stages of the disease. Finally, because the loss of dopamine producing cells seems to affect so many other pathways in the brain, many people with Parkinson's disease benefit from antidepressant therapy or medication.


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